Alipour-Faz A, Shojaei M, Peyvandi H. A Comparison Between IVIg and Plasma Exchange as Preparations Before Thymectomy in Myasthenia Gravis Patients. Acta Neurol Belg in press.
Submitted by Andrew W. Tarulli, MD, News Science Editorial Board
A small randomized study was conducted in patients with myasthenia gravis who were scheduled to undergo thymectomy. Twenty-four patients were randomized to receive either IVIg 1 g/kg/day x 2 consecutive days or plasma exchange 5 times every other day. Treatments were administered between 10-30 days before the procedure. Post-operative intubation was more common and duration of treatment was longer in patients treated with plasma exchange. There were no differences in duration of hospitalization, length of ICU stay, or post-operative corticosteroid dose between the two groups.
Although a small study, this report suggests that IVIg and plasma exchange may be comparable preparatory treatments for patients undergoing thymectomy. Traditionally, plasma exchange has been employed as the pre-thymectomy treatment of choice, but the greater convenience of administering IVIg may make it the preferred treatment in anticipation of thymectomy.
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