High-dose intravenous immunoglobulin for the treatment of MuSK antibody-positive seronegative myasthenia gravis

J Neurol Sci. 2006 Sep 25;247(2):239-41. doi: 10.1016/j.jns.2006.05.065. Epub 2006 Jul 28.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies / metabolism
  • Female
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Middle Aged
  • Myasthenia Gravis / immunology*
  • Myasthenia Gravis / therapy*
  • Receptor Protein-Tyrosine Kinases / immunology*
  • Receptors, Cholinergic / immunology*
  • Time Factors

Substances

  • Antibodies
  • Immunoglobulins, Intravenous
  • Receptors, Cholinergic
  • MUSK protein, human
  • Receptor Protein-Tyrosine Kinases