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A comparison between IVIG and plasma exchange as preparations before thymectomy in myasthenia gravis patients

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Abstract

Myasthenia gravis (MG) is one of the curable neurologic disorders. Various pharmacological therapies are administered for these patients and a thymectomy plays an important role in the therapy of myasthenia gravis, which develops a permanent or relative remission. We investigated the efficacy of intravenous immunoglobulin (IVIG) and plasma exchange (PLEX) as a preparation before thymectomy in patients with MG. This randomized clinical trial was conducted on 24 patients with MG referred for thymectomy, which were randomized to two groups of IVIG and PLEX. The IVIG group received IVIG 1 g/kg/day for two consecutive days and the PLEX group underwent 1-L plasma exchange five times with 5 % albumin replacement fluid, every other day, 10–30 days before the procedure. The duration of hospitalization (day), length of intensive care unit (ICU) stay after surgery (day), length of intubation period (h), duration of surgery (h) and dose of steroid administered were compared between the two groups. Analysis was performed via SPSS version 20. In the PLEX group, post-operative outcomes (duration of hospitalization, ICU length of stay after surgery, intubation period and duration of surgery) were longer than those in the IVIG group. There was significant difference in intubation period (p value = 0.01) and duration of surgery (p value = 0.05) between the PLEX and IVIG groups. The administration of IVIG in comparison to PLEX can be more effective in the preparation before thymectomy in myasthenia gravis patients.

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Acknowledgements

The authors would like to thank the patients, the medical and nursing staff and the Clinical Research Development Center in Loghman Hakim Hospital of Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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Authors and Affiliations

  1. Researcher, Clinical Research Development Center of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Athena Alipour-Faz, Davood Ramzi & Maryam Peyvandi

  2. Department of Neurology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Maziar Shojaei & Fereshteh Ghadiri

  3. Associate Professor of General Surgery, Hearing Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Hassan Peyvandi

  4. Community Medicine, Clinical Research Development Center of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mahbobeh Oroei

Authors
  1. Athena Alipour-Faz
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  2. Maziar Shojaei
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  3. Hassan Peyvandi
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  4. Davood Ramzi
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  5. Mahbobeh Oroei
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  6. Fereshteh Ghadiri
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  7. Maryam Peyvandi
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Correspondence to Hassan Peyvandi.

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The authors declare no conflict of interest related to the present work.

Ethical standards

The study was approved by the local Ethics Committee of Shahid Beheshti university of medical sciences, Tehran, iran.

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We received no funding in the preparation of this manuscript.

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The patient provided written informed consent for the study participation.

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Alipour-Faz, A., Shojaei, M., Peyvandi, H. et al. A comparison between IVIG and plasma exchange as preparations before thymectomy in myasthenia gravis patients. Acta Neurol Belg 117, 245–249 (2017). https://doi.org/10.1007/s13760-016-0689-z

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  • DOI: https://doi.org/10.1007/s13760-016-0689-z

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