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Myasthenia Gravis

IVIG treatment for MG

09/08/2008

Question:

I read an article that mentioned if you don`t use IVIG early after being diagnosed it is not as effective. I started taking IVIG treatments about one year after diagnoised. I have been on the treatments for about 2 years now. Have not noticed much improvement. When should neurologist stop treatments? Their very expensive

Answer:

IVIG, or intravenous immunoglobulin, is used for the treatment of myasthenia gravis as a booster and as a treatment for myasthenic crisis. It can be very variable in response time, but if some response isn't seen within the first 2-3 weeks of treatment, it might not be as effective as planned. One study showed 70% of patients responded favorably to IVIG; that means another 30% did not respond to the treatment. Disease symptoms return in 5-10 weeks, depending on severity of the disease. More recent studies are suggesting that IVIG might be a better treatment only for the acute form of the disease, especially crisis. Milder symptoms usually do not do as well with the IVIG in most the reports I have read. I am not sure it has anything to do with when you started the treatment. There is also the question of autoimmune versus congenital myasthenia, and congenital myasthenia does not respond well to IVIG. Cost and effectiveness are both very important issues to talk about with your treating physician.

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Response by:

Robert W Neel, IV, MD Robert W Neel, IV, MD
Assistant Professor of Neurology
College of Medicine
University of Cincinnati