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High-dose intravenous immunoglobulin for the treatment of MuSK antibody-positive seronegative myasthenia gravis.
J Neurol Sci. 2006 Jul 27
Takahashi H, Kawaguchi N, Nemoto Y, Hattori T.
Department of Neurology, Graduate School of Medicine, Chiba University, Japan.
We
treated two patients with anti-muscle specific tyrosine kinase
(MuSK)-antibody positive seronegative myasthenia gravis (MG) with
high-dose intravenous gammaglobulin (IVIg) and evaluated their clinical
courses. Both patients were Japanese women, MuSK-positive seronegative
MG, and were unresponsive to conventional treatments, including
thymectomy, steroids, and tacrolimus.
The patients required frequent
hospitalization for plasmapheresis. In case 1, a 45-year-old woman, it
was difficult to obtain blood access for plasmapheresis. High-dose
IVIg, 400 mg/kg per day for 5 days, was administered in cases 1 and 2.
In both cases, clinical improvement was observed 3 days after the start
of IVIg therapy and lasted for 2 to 3 months. We propose that IVIg
therapy is an effective treatment for MuSK-positive seronegative MG,
when conventional treatments have failed.
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