Intravenous immunoglobulin in the preparation of thymectomy for myasthenia gravis.
OBJECTIVE
A clinical trial including six patients was conducted to assess the effect of intravenous immunoglobulin (IVIg) in the preparation of thymectomy for patients with myasthenia gravis (MG).


METHODS
Six consecutive patients of type IIB MG treated with IVIg at a dose 0.4 g/kg daily for 5 days before thymectomy were enrolled in this study.


RESULTS
All patients responded positively to this treatment. Improvement began to occur 1-9 days after starting the injection (mean 3.33 days), and reached a maximum in 3-19 days (mean 6.50 days). Thymectomy was performed 9-13 days (mean 11.20 days) after starting the injection in five of the six patients with uneventful post-operative courses.


CONCLUSIONS
IVIg might be an alternative to plasmapheresis (PE) in the prethymectomy preparation of MG patients, and thymectomy should be performed within 2 weeks after IVIg treatment to minimize the perioperative complications. Controlled trial vs PE enrolling more patients is needed to assess the significance of the IVIg in the preparation of thymectomy for patients of MG.
Huang
C-S
CS
Division of Thoracic Surgery, Department of Surgery, Veterans General Hospital-Taipei and National Yang-Ming University School of Medicine, Taipei, Taiwan.
Hsu
H-S
HS
Kao
K-P
KP
Huang
M-H
MH
Huang
B-S
BS
D000328:Adult; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000188:drug therapy* / Q000601:surgery*; D013934:Thymectomy
D016756:Immunoglobulins, Intravenous