Intravenous Immunoglobulins Efficacy in a Case of ALS with Myasthenic Symptoms

Myasthenia Gravis (MG) is a neuromuscular junction disease, for which the most specific test is an increase in anti-acetylcholine receptor antibodies (anti-ACHR-Abs) titer. Myasthenic symptoms are rarely detected in patients with Amyotrophic Lateral Sclerosis (ALS). We report the case of a patient with sporadic ALS who presented at onset clinical and instrumental features suggestive of a disorder of the neuromuscular junction. She was treated with intravenous immunoglobulins for two years, with sensitive improvement in strength and delay of disease progression. The efficacy of such immunomodulating treatment in our unusual case leads to rethink the role of immune response in ALS.