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Merck
  • Successful treatment of severe myasthenia gravis developed after allogeneic hematopoietic stem cell transplantation with plasma exchange and rituximab.

Successful treatment of severe myasthenia gravis developed after allogeneic hematopoietic stem cell transplantation with plasma exchange and rituximab.

Pediatric blood & cancer (2013-12-07)
Sule Unal, Erdal Sag, Baris Kuskonmaz, Selman Kesici, Benan Bayrakci, Deniz C Ayvaz, Ilhan Tezcan, Dilek Yalnızoglu, Duygu Uckan
ABSTRACT

Myasthenia gravis is among the rare complications after allogeneic hematopoietic stem cell transplantation and is usually associated with chronic GVHD. Herein, we report a 2-year and 10 months of age female with Griscelli syndrome, who developed severe myasthenia gravis at post-transplant +22nd month and required respiratory support with mechanical ventilation. She was unresponsive to cyclosporine A, methylprednisolone, intravenous immunoglobulin, and mycophenolate mofetil and the symptoms could only be controlled after plasma exchange and subsequent use of rituximab, in addition to cyclosporine A and mycophenolate mofetil maintenance. She is currently asymptomatic on the 6th month of follow-up.

MATERIALS
Product Number
Brand
Product Description

Supelco
Cyclosporin A, VETRANAL®, analytical standard
Sigma-Aldrich
Cyclosporin A, 97.0-101.5% (on dried basis)
Sigma-Aldrich
Cyclosporin A, from Tolypocladium inflatum, ≥95% (HPLC), solid
Supelco
Mycophenolic acid solution, 1.0 mg/mL in acetonitrile, ampule of 1 mL, certified reference material, Cerilliant®
Sigma-Aldrich
Cyclosporin A, BioReagent, from Tolypocladium inflatum, for molecular biology, ≥95%
USP
Mycophenolate mofetil, United States Pharmacopeia (USP) Reference Standard
Sigma-Aldrich
Mycophenolate mofetil, ≥98% (HPLC)
Mycophenolate mofetil, European Pharmacopoeia (EP) Reference Standard
Supelco
Cyclosporine, Pharmaceutical Secondary Standard; Certified Reference Material
Sigma-Aldrich
Mycophenolic acid, ≥98%
Sigma-Aldrich
Mycophenolic acid, powder, BioReagent, suitable for cell culture
Supelco
Cyclosporin A solution, 1.0 mg/mL in acetonitrile, ampule of 1 mL, certified reference material, Cerilliant®
Supelco
Mycophenolic acid, analytical standard
Mycophenolate mofetil for peak identification, European Pharmacopoeia (EP) Reference Standard
Ciclosporin, European Pharmacopoeia (EP) Reference Standard