title: The effect of intravenous immunoglobulin on neuromyelitis optica.
abstract: OBJECTIVE
  Evaluate safety and tolerance levels for intravenous immunoglobulins (IVIG) as treatment for neuromyelitis optica (NMO).
  
  
  METHODS
  Eight patients meeting Wingerchuk's revised diagnostic criteria were treated with IVIG every 2 months (0.7 g per kg body weight per day for 3 days). The primary outcome measure was the occurrence of serious adverse effects, defined according to NIH guidelines for clinical trials. Secondary outcome measures were changes in the yearly rate of attacks and in the degree of neurological disability measured with the Expanded Disability Status Scale (EDSS).
  
  
  RESULTS
  All 8 patients were treated; 5 had relapsing optic neuritis with or without myelitis and 3 had recurrent longitudinally extensive transverse myelitis. The mean age of onset was 20.5 years (range, 7-31 years) and 87,5% were female. The mean duration of the disease before beginning treatment was 9.0 years (range, 3-17 years). Following 83 infusions (range, 4-21 per patient) and a mean follow-up time of 19.3 months (range, 6-39 months), minor adverse events had occurred (headache in 3 patients and a mild cutaneous eruption in a single patient). The relapse rate decreased from 1.8 in the previous year to 0.006 during follow-up (z=2,5, P=.01). The EDSS score fell from 3.3±1.3 to 2.6±1.5 (z=-2.0, P=.04).
  
  
  CONCLUSIONS
  Treatment with IVIG is safe and well-tolerated, and it may be used as a treatment alternative for NMO spectrum disorders.
authors: Unidad de Esclerosis Múltiple, Servicio de Neurología, Hospital Universitario y Politécnico La Fe, Valencia, España. majomagbe@ono.com
authors: M J
authors: MJ
authors: Magraner
authors: F
authors: F
authors: Coret
authors: B
authors: B
authors: Casanova
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D004185:Disability Evaluation; D003875:Drug Eruptions; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D009471:Neuromyelitis Optica / Q000628:therapy*; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous