Manipulating the Immune System with Immune Globulin

To the Editor: I believe that the recent article by Dwyer (Jan. 9 issue)¹ contains misstatements about the neurologic diseases discussed and probably overestimates the efficacy of intravenous immune globulin in those diseases. The section describing the effect of this therapy in patients with myasthenia gravis implies that it is useful, on the basis of results achieved in “more than 60 patients.” It is likely that many more than 60 patients have received this therapy but did not respond and that, therefore, their cases were not reported. Thus, the conclusions about efficacy may not reflect the outcome of the therapy…