Jana, Hi. I hope you've been doing okay. Glad to see you back here.
I don't have too much energy for searching right now but here are a few. The basic premise behind immunosuppression is to keep antibodies from forming so that they won't attack the NMJ, which I'm sure you already know. They are still looking into exactly how each drug works, or doesn't work, in people with MG.
http://www.macalester.edu/psychology...ppression.html
http://www.ncbi.nlm.nih.gov/pubmed/183592
This is a small study.
http://www.roche-trials.com/studyRes...Number=WX17798
Quote:
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In addition, CellCept patients showed a larger decline in AChR antibody titers (with median values of 8.00 nmol/L at Week 0 and 3.46 nmol/L at Week 36) compared to patients in the placebo group (with median values of 8.00 nmol/L at Week 0 and 7.61 nmol/L at Week 36); this difference suggests CellCept may play a role in decreasing circulating AChR antibody levels over the course of 36 weeks.
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The bottom line is that, yes, after immunosuppression of any kind, AChR antibodies do disappear. At least in the circulating blood. And it all depends on how high someone's antibodies are to begin with. Unless they carve all of us open, they can't say for certain if an amount of them stay in the NMJ causing damage. I can't find any articles that call this antibody attack "fluid" or something that comes and goes. By that I mean do the antibodies "hang out" in the NMJ, causing more and more damage or do they "die off." Maybe someone else has the answer to that.
There are "tissue bound" antibodies and those that end up "circulating" in the blood.
I wish I had a better source for your friend. Sometimes it's more important to treat the disease right away, to save a patient, than to do a thorough diagnosis. And once you are on those big drugs, especially Pred, it's so hard to go off of them simply to have a test done.
The SFEMG goes negative too with those drugs, plus with Mestinon.
Did she have a bad reaction to the IVIG itself or regular side effects or the type of IVIG or the "delivery route?" I suppose they could try subcutaneous IVIG, in a hospital setting.
Google "immunosuppressive effects AChR antibodies" and searches like that to find more info.
Take care,
Annie