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Clinical Trial of Plasma Exchange and High-dose Intravenous Immunoglobulin in Myasthenia Gravis Ann Neurol 41:789-796, Gajdos,P.,et al, 1997 See this aricle in Pubmed Article Abstract We have conducted a trial to randomly assess the efficacy and tolerance of intravenous immunoglobulin(IVIg)or plasma exchange(PE)in myasthenia gravis (MG)exacerbation and to compare two doses of IVIg.Eighty-seven patients with MG exacerbation were randomized to receive either three PE(n=41),or IVIg(n=46).0.4 gm/kg daily further allocated to 3(n=23)or 5 days(n=23).The main end point was the variation of a myasthenic muscular score(MSS) between randomization and day 15.The MSS variation was similar in both groups(median value.+18 in the PE group and+15.5 in the IVIg group;p=0.65. Similar efficacy,although slightly reduced in the 5 day group was observed with both IVIg schedules.The tolerance of IVIg was better than that of PE with a total of 14 side effects observed in 9 patients,8 in the PE group and 1 in the IVIg group(p=0.01).Although our trial failed to show a pronounced difference in the efficacy of both treatments,it exhibited a very limited risk for IVIg.IVIg is an alternative for the treatment of myasthenic crisis.The small sample sizes in our trial,however,could explain why a difference in efficacy was not observed.Further studies are needed to compare PE with IVIg and to determine the optimal dosage of IVIg.

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(click to filter results - removes previous filter) gammaglobulin therapy,intravenous myasthenia gravis myasthenia gravis,exacerbation myasthenia gravis,treatment of myasthenic crisis plasmapheresis treatment of neurologic disorder

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