ABSTRACT
Pregnancy is generally considered a low-risk period for an exacerbation of multiple sclerosis (MS), whereas the period immediately after delivery is considered a high-risk one.1-9 It has been hypothesized that immunoregulatory mechanisms during pregnancy and the puerperium are responsible for those changes also seen in many other autoimmune diseases (myasthenia gravis, lupus erythymatosus, rheumatoid arthritis). Intravenous γ-globulin (IVIg) is the treatment of choice in some diseases, namely primary and secondary immunodeficiency and idiopathic thrombocytopenic purpura. Evolving indications of IVIg, include spontaneous abortion, sepsis and prevention of relapses in MS. Several studies have shown a beneficial effect in relapsing-remitting MS (RRMS), an effect that has also been attributed to immunoregulatory mechanisms.5,7,8,10,11,13 Controlled trials in secondary progressive MS (SPMS) are ongoing.
