Intravenous immune globin (IVIG) swamps the body with pooled gamma globulin antibodies from many donors. The process does not require special equipment, and the usual dose is small (eg 400 mg per kilogram per day infused at a time). Whilst the mechanism of action remains unknown, IVIG is thought to have a nonspecific suppressive effect upon the production of antibody by the immune system. It produces rapid improvement to help patient through a difficult period of myasthenic weakness. In patients who respond, improvement begins within four or five days, and may be sustained for weeks to months.
The process is quite expensive, and the treatment is short term (i.e. weeks). IVIG use is really limited to critical patients or those who are not responding to traditional treatments. It should be noted that there is a theoretical risk of transmission of blood born infections, although this has not happened now for some years.
Adverse reaction occur in fewer than 10 percent of patients. Symptoms include headache, fluid overload, and in rare cases, renal failure. Plenty of fluids should accompany the treatments to minimize the severe headache which can occur.
