[A comparative study of intravenous immunoglobulin and plasmapheresis preoperatively in myasthenia]

Thymectomy is a well established procedure in myasthenia gravis (MG). To reduce its morbidity, treatments which are effective in the short term, such as plasmapheresis and intravenous immunoglobulin (IGI) have been used.

To evaluate the efficacy and tolerability of the IGI, compared with plasmapheresis, in the preparation of myasthenic patients before thymectomy.

We compared a group of 33 prospective myasthenic patients treated with IGI with 38 clinical histories taken as controls treated by plasmapheresis during the peri operative period of thymectomy.

The patients treated with IGI were in the intensive care unit and neurology ward for less time. The endotracheal tube was also removed sooner. However, these differences were not significant. The commonest complications of IGI were fever, shivering and phlebitis. The most frequent adverse reaction to plasmapheresis were cutaneous eruptions. One patient developed Hepatitis C after plasmapheresis.

IGI is comparable in efficacy to plasmapheresis in the peri operative period of MG, but has a better profile of adverse reactions.