title: Subcutaneous immunoglobulin in treating inflammatory neuromuscular disorders.
abstract: OBJECTIVE
  Intravenous immunoglobulin administration has long been used in the treatment of autoimmune neuromuscular disorders. Immunoglobulins may be administered by intramuscular, intravenous or subcutaneous routes.
  
  
  METHODS
  This is a report on the long-term clinical follow up of six patients with inflammatory neuromuscular disorders, that is, three chronic inflammatory demyelinating polyneuropathy (CIDP), one multifocal motor neuropathy (MMN), one inclusion body myositis (IBM) and one myasthenia gravis (MG), treated with subcutaneous immunoglobulins for a mean of 3.25 years.
  
  
  RESULTS
  One MMN and two CIDP patients received a weekly dose of subcutaneous immunoglobulins equivalent to intravenous immunoglobulin. One CIDP patient received a 50% dose reduction, the IBM patient received a 30% reduction and the MG patient a 20% reduction. The lower dose chosen in the majority of patients was based not only on clinical effects, but also on studies of primary immunodeficiency syndromes. One patient with CIDP showed clinical fluctuation, which was successfully treated with an adaptation of the dose of subcutaneous immunoglobulins, while the remaining patients with neuromuscular disorders had a stable clinical course for 2 years. No serious side effects were observed.
  
  
  CONCLUSIONS
  Our results suggest that subcutaneous immunoglobulins can be an attractive alternative therapy in autoimmune neuromuscular disorders.
authors.affiliation: Department of Neurology, Ruhr University, Bochum, Germany.
authors.forename: Min-Suk
authors.initials: MS
authors.lastname: Yoon
authors.affiliation: Department of Neurology, Ruhr University, Bochum, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Gold
authors.affiliation: Department of Neurology, St. Josef-Hospital, Ruhr University, Gudrunstr. 56, 44791 Bochum, Germany.
authors.forename: Antonios
authors.initials: A
authors.lastname: Kerasnoudis
keywords: chronic inflammatory demyelinating polyneuropathy; inclusion body myositis; multifocal motor neuropathy; myasthenia gravis; subcutaneous immunoglobulin