Ten children (median age, 13 years; range, 3-18 yrs) with juvenile myasthenia gravis were treated with high-dose intravenous immunoglobulin (2 gm/kg body wt) and prospectively evaluated for 5 years at the Department of Neurology, Wayne State University, Children’s Hospital of Michigan, Detroit, MI. Improvement in functional strength occurred initially in 8 patients, but the response decreased after multiple monthly treatments. No correlation was noted between clinical response and a decrease in anti-AChR antibody levels measured in 3 patients. One child developed hypotension during the infusion and treatment was discontinued. Six patients complained of headache. [1]
COMMENT. High-dose IV immunoglobulin may be of benefit in juvenile myasthenia gravis as a short-term therapy, at times of myasthenic crisis, and in preparation for surgery.