High-Dose Intravenous Immunoglobulin in the Management of Myasthenia Gravis

I. Bonaventura, MD; J. PONSETI, MD; E. Arnau, MD; J. Matias-Guiu, MD; A. Codina Puiggros, MD
Arch Intern Med. 1987;147(2):207-211. doi:10.1001/archinte.1987.00370020027019.
Text Size: A A A
Published online

To the Editor.  —We have read with interest the article by Arsura et al1 concerning 12 cases that were treated with high-dose intravenous immunoglobulin therapy for exacerbations of generalized myasthenia gravis. As all of their patients had elevated acetylcholine-receptor antibody (AChR) titers, the authors theorized that a possible mechanism of this therapy is the interference of the interaction of the acetylcholine receptor with AChR antibody. Nevertheless, we have recently described2 a 14-year-old patient with myasthenia gravis without AChR antibody who was successfully treated with high-dose intravenous immunoglobulin therapy. A diagnosis of congenital myasthenic syndrome had been excluded. Our patient was classified as grade III according to the criteria of Osserman. She experienced a severe exacerbation of the disease. High-dose prednisone and anticholinesterase therapies failed to improve her condition within 45 days. Intravenous 7S immunoglobulin was administered with a loading dose of 400 mg/kg daily over five consecutive days.


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.