Immediate effects of intravenous IgG administration on peripheral blood B and T cells and polymorphonuclear cells in patients with myasthenia gravis.

Five patients with myasthenia gravis, who received treatment with intravenous 7S gamma-globulin were monitored for changes in immunological status. Serum immunoglobulin G increased from an average of 1.4 to 4.7 g/dl during the 5-day course of therapy. Specific antibody to the acetylcholine receptor present in three of five patients did not change. A transient decrease in total peripheral blood leukocytes was observed in five patients due to decreases in the absolute number of polymorphonuclear cells and lymphocytes in the circulation. Lymphocyte surface marker studies revealed that the percentage of surface immunoglobulin positive cells increased in all patients from an average of 13 to 26% by day 5 of therapy; however, the percentage of HLA-Dr- and Leu 12 (CD19)-positive B cells did not change. Lymphoid cells positive for the Leu 11 (CD16) marker doubled from an average of 11 to 24% during the 5-day course of therapy. Surface Ig-positive cells and Leu 11 (CD16)-positive cells returned to pretreatment values by 7 days posttherapy. Helper/suppressor cell ratios slowly decreased in all patients from an average of 2.9 to 2.2 by 1 week posttherapy and remained low for several weeks.