HIGH-DOSE INTRAVENOUS IMMUNOGLOBULIN IN MYASTHENIA-GRAVIS

The effects of high-dose intravenous immunoglobulin (i.v.Ig) in 12 MG patients were studied. All patients had severe symptoms. In two cases anti-acetylcholine receptor antibodies (anti-AChR abs) were not detect able. I.v.Ig was administered to 9 patients already on long-term immun osuppressive therapy and to 3 patients at the beginning of azathioprin e treatment. 10 patients (83%) improved; the duration of improvement w as longer in immunosuppressed patients. Anti-A ChR abs generally decre ased after infusion but we did not find a constant correlation between reduction in ab titers and clinical improvement. Side effects include d one case of severe hemolysis. In our experience i.v.Ig therapy is ef fective in MG. The chief indication for its use appears to be the trea tment of deterioration of the disease in patients already on immunosup pressive therapy.