How the application of human immunoglobulin in the treatment of myasthenia crisis changed the outcome of the disease.

INTRODUCTION Myasthenia gravis (MG) is an autoimmune disease characterized by weakness and fluctuating pathological tiredness of cross-striped muscle with improvement after rest. GOAL To compare the outcomes of treatment in myasthenic crisis therapy and conventional therapy with high doses of human immunoglobulin. Epidemiological research, mainly retrospective, partly prospective, descriptive-analytical and clinical-application nature, was carried out on Neurology Clinic Clinical Center University of Sarajevo in the period from January 1st 2002 to December 31st 2008. RESULTS Total of 25 patients were examined, with more women (2.5: 1), with women average age 40 years (SD = 15.2) and men average age 54.3 years (SD = 19.6). Men with myasthenia gravis had the disease duration longer than 15 years with generalized form of myasthenia gravis dominant (60%). Women with myasthenia gravis had more intensive symptoms of the disease (p < 0.01), which ultimately did not lead to significantly higher lethal outcomes. Almost 90% of the respondents were repeatedly hospitalized. All our respondents were treated with anticholinesterarasis therapy with a significant change in the outcome of treatment (which was primarily lethal) brought with human immunoglobulins (introduced at our Clinic in 2003). It is important to note that since then we have no lethal outcomes. Half of the female and 43% of male patients after the treatment had stable remission and were released without MG symptoms, while 28% of patients additionally had improved status. Lethal outcome, primarily due to cardiopulmonal relaxation, was in 28.6% men and 22.2% of women with myasthenia.

[1]  John C. Keesey,et al.  Clinical evaluation and management of myasthenia gravis , 2004, Muscle & nerve.

[2]  J. Palace,et al.  Myasthenia gravis: diagnostic and management dilemmas , 2001, Current opinion in neurology.

[3]  I. Tsiropoulos,et al.  Mortality and survival in myasthenia gravis: a Danish population based study , 1998, Journal of neurology, neurosurgery, and psychiatry.

[4]  D. Schneider,et al.  Therapy of myasthenic crisis. , 1997, Critical care medicine.

[5]  J. Kuks,et al.  Myasthenia gravis: diagnosis and follow-up of 100 consecutive patients , 1997, Journal of Neurology.

[6]  N. Keiding,et al.  Epidemiology of myasthenia gravis in Denmark. A longitudinal and comprehensive population survey. , 1991, Archives of neurology.

[7]  H. Oosterhuis The natural course of myasthenia gravis: a long term follow up study. , 1989, Journal of neurology, neurosurgery, and psychiatry.

[8]  M. Giagheddu,et al.  Epidemiological study of myasthenia gravis in Sardinia, Italy (1958–1986) , 1989, Acta neurologica Scandinavica.

[9]  D. Grob,et al.  The Course of Myasthenia Gravis and Therapies Affecting Outcome a , 1987, Annals of the New York Academy of Sciences.

[10]  D. Elmqvist Myasthenia Gravis , 1975, The Lancet.

[11]  R. Hohlfeld,et al.  Therapy of Myasthenia Gravis and Myasthenic Syndromes , 2003 .

[12]  G. Ferrari,et al.  Epidemiology of myasthenia gravis in the province of Trento (northern Italy). , 1992, Neuroepidemiology.

[13]  T. Sørensen,et al.  Myasthenia gravis in the county of Viborg, Denmark. , 1989, European neurology.