Dear patient. Greetings from health care magic!!! I am Dr Thakker and shall be answering your question. I can understand your reservations about using IVIG for Myasthenia Gravis, especially when plasmapheresis has worked well for you. I will try my best to answer your question and guide you through the problem. Myasthenia gravis is an autoimmune disease of neuro-muscular junction. There are antibodies in the blood again the Ach receptors present at the neuro-muscular junction. Treatment for MG is either plasmapheresis or IVIG. In plasmapheresis, the patient plasma (and antibodies in it) is separated on a hemodialysis machine and it is replaced with albumin. The lost plasma is resynthesized in the body. This process is invasive as one needs to do a Joe catheter insertion in the neck vein IJV. There is a risk of hypotension on plasmpheresis due to rapid flux of plasma on the machine. There is a risk of electrolyte imbalance as well. All these complications increase the mortality rates of plasmapheresis. On the other hand IVIG contains immunoglobulins which neutralize the circulating antibodies against the ach-r. This does not need Joe catheter insertion, no chances to electrolyte imbalance and hypotension. Thus it is much safer. Hence in your case the doctor has preferred IVIG over plasmapheresis mainly from a safety point of view. Along with this prednisolone, azathioprine and other immune suppressants are also used. Thymectomy is also helpful. I hope this helps you out. If you have any more questions, please do not hesitate to write back to me. Yours sincerely, Dr Thakker.