High doses of intravenous gamma globulin in the treatment of myasthenia gravis
Fort López-Barajas, J.M.; Ponseti Bosch, J.M.
Medicina Clinica 91(9): 325-328
1988
ISSN/ISBN: 0025-7753 PMID: 3216754 Document Number: 326123
We report our results in the therapy of high dose intravenous gamma globulin (7S IGG) in six females with myasthenia gravis (MG). Five of them were treated for residual post-thymectomy symptoms, while the remaining one was treated as a preparation for operation, as she had the acute generalized form of the disease with bulbar and respiratory impairment (Osserman's grade III). The administration of 400 mg per kg of body weight and day for five days resulted in global increases in muscular strength in all patients, with variations in their functional status of 1.4 .+-. 0,8 (x .+-. SD) with p = 0.001. The improvement started between the third and the seventh day (5.6 .+-. 1.6), reaching a peak between the fourth and the sixth weeks. In four patients the effect was sustained for three months, in another the clinical remission is still persisting, whereas in the remaining one the effect was virtually absent. We think that therapy with 7S lgG, owing to its high efficacy, rapid action, sustained effect and virtually absent side effects, is superior to plasmapheresis for the therapy of severe exacerbations of generalized MG that are not controlled with conventional therapy. However, its high cost makes strict patient selection mandatory.