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.