As for why you need repeated courses of IVIG or infusions.
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IVIG does not affect your immune systems ability to produce immune globulins; it simply increases the antibody level within your body. Antibodies whether those produced naturally by your body or those infused in the form of IVIG are eventually metabolized and eliminated by your body, usually in about 3-4 weeks. Regular infusions are necessary to maintain immune globulin levels within the desired range.
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When I was first diagnosed I eventually had a course of IVIG but prior to that for some reason I had never been given Prednisolone only mestinon.
On the last day and the last bottle I had a severe reaction and have had no further infusions and as I said on inquiring of my neuro if it was possible now after such a long interval to have it again was told it was policy to give IVIG only if in crisis I don't agree with it but it is what I was told. So I can only assume it's about cost not clinical need because I spend most of the time hovering on the edge of a crisis and I hate it.