Reduction of IgG Levels in Myasthenia

To the Editor: Further clarification of the possible autoimmune nature of myasthenia gravis is presented in a recent Journal article by Toyka et al.¹ and extends previous work by the same investigators² and others.³ Implications for therapy, however, are not nearly as clear. The role of corticosteroids in the treatment of this disorder remains controversial, and the myriad side effects of these potent compounds are well known. If an analogy is drawn between the beneficial effects of lowering serum antibody levels in glomerulonephritis associated with circulating anti-glomerular-basement-membrane antibodies⁴ and the potential benefit of lowering immunoglobulin levels in myasthenia gravis,.