High-Dose Intravenous Gammaglobulin for Myasthenia Gravis

Ippoliti, G; Cosi, V.; Piccolo, G.; Lombardi, M.; Mantegaz, R.; Devathasan, G; Kueh, Y K; Chong, P.N.

doi:10.1016/s0140-6736(84)90729-3

Cited by 48 publications

(22 citation statements)

References 4 publications

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“…The normal pooled Ig might contain anti-idiotypic abs which would either block the binding of pathogenic abs to AChR or inhibit specific B cell clones [12,16]. A decrease in anti-AChR ab levels after this treatment has been found by some authors [5][6][7][8][9][10] and not by others [11][12][13][14][15]. A decrease in anti-AChR ab levels after this treatment has been found by some authors [5][6][7][8][9][10] and not by others [11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

High-dose intravenous immunoglobulin in myasthenia gravis

et al. 1993

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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 detectable. I.v.Ig was administered to 9 patients already on long-term immunosuppressive therapy and to 3 patients at the beginning of azathioprine treatment. 10 patients (83%) improved; the duration of improvement was longer in immunosuppressed patients. Anti-AChR abs generally decreased after infusion but we did not find a constant correlation between reduction in ab titers and clinical improvement. Side effects included one case of severe hemolysis. In our experience i.v.Ig therapy is effective in MG. The chief indication for its use appears to be the treatment of deterioration of the disease in patients already on immunosuppressive therapy.

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Section: Discussionmentioning

confidence: 99%

High-dose intravenous immunoglobulin in myasthenia gravis

et al. 1993

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“…Blutaustauschtransfusion und die Gabe von Immunglobulinen (IgG i.v.) eingesetzt [2,3,6,9,11,13,14,18,27,32]. Während Plasmapherese bzw.…”

Section: Therapieunclassified

Transiente neonatale Myasthenia gravis

et al. 2002

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Ten to twenty percent of the offspring of mothers suffering from myasthenia gravis (MG) also develop transient neonatal MG, since maternal antibodies are able to cross the placenta. We report the course of two newborns of a mother with MG and a healthy father. The first pregnancy was complicated during the 3rd trimester by a hydramnion. The newborn presented with generalized muscle weakness, respiratory distress, weak sounding, anaemia, and poor sucking. Mechanical ventilation was necessary. Confirmation of the diagnosis was achieved by the result of repetitive muscle stimulation, showing a typical decrement in the EMG, and measurement of serum antiacetylcholin receptor antibodies. For 3 months, the infant was treated with neostigmin (cholinesterase inhibitor). After 26 days of hospitalization, the patient was released and followed up regularly. Myasthenic symptoms completely resolved. Side effects of the treatment were not observed. The course of the second pregnancy was normal. This second newborn was healthy. Our case report is remarkable for the very different presentation of two children of the same mother with MG during pregnancy and after delivery, with one child developing severe transient neonatal MG, initially requiring intensive care unit (ICU) treatment followed by quick recovery, and one child being healthy. We also present a score for monitoring the clinical course and adjusting anticholinesterase therapy accordingly.

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“…Furthermore, recent success of high-dose human intravenous gammaglobulin, a nonspecific immunosuppressant, in the treatment of myasthenia gravis [27][28][29][30][31] supports the use of polyclonal antibody therapy in myasthenia gravis. EAMG provides a useful model of evaluating immunologic therapies in myasthenia gravis [1, 2, 4, 5],…”

Section: Discussionmentioning

confidence: 98%

Prevention and Treatment of Experimental Autoimmune Myasthenia gravis with Anti-Rabbit Thymocyte Serum and Gammaglobulin in Rabbits

Scelsa¹,

Frost²,

Valderrama³

et al. 1995

Pathobiology

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Twenty-two rabbits received Torpedo californica acetylcholine receptor (AChR) subcutaneously. Six rabbits were treated with 0.5 ml/kg/day of anti-rabbit thymocyte serum (ARTS), and four were treated with 5.0 mg/kg/day of anti-rabbit thymocyte gammaglobulin (ARTG) subcutaneously beginning concomitantly 1, 2 and 3 weeks after the initial AChR immunization. All 12 control animals died of experimental autoimmune myasthenia gravis (EAMG) within 52 days. None of the 10 treated rabbits developed clinical EAMG. ARTS- and ARTG-treated animals had significantly lower anti-AChR antibody titers than control animals at 3 weeks (pre-AChR booster, p& < 0.01). At 6 weeks (post-AChR booster), only ARTS-treated animals had significantly lower titers than controls (p& < 0.01). ARTS-treated animals developed sterile abscesses at injection sites, which were minimal in the ARTG-treated group. ARTS and ARTG prevent EAMG.

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High-Dose Intravenous Gammaglobulin for Myasthenia Gravis

Cited by 48 publications

References 4 publications

High-dose intravenous immunoglobulin in myasthenia gravis

High-dose intravenous immunoglobulin in myasthenia gravis

Transiente neonatale Myasthenia gravis

Prevention and Treatment of Experimental Autoimmune Myasthenia gravis with Anti-Rabbit Thymocyte Serum and Gammaglobulin in Rabbits

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