Severe worsening of myasthenic symptoms after the eculizumab discontinuation.


Journal

Journal of neuroimmunology
ISSN: 1872-8421
Titre abrégé: J Neuroimmunol
Pays: Netherlands
ID NLM: 8109498

Informations de publication

Date de publication:
15 12 2020
Historique:
received: 30 06 2020
revised: 29 07 2020
accepted: 05 10 2020
pubmed: 18 10 2020
medline: 17 12 2020
entrez: 17 10 2020
Statut: ppublish

Résumé

Myasthenia gravis (MG) is an autoantibody-mediated disease of the neuromuscular junction. The neuromuscular junction damage associated with MG is caused by anti-acetylcholine receptor (AChR) antibody and complements. Recently, eculizumab (an anti-C5 monoclonal antibody) was approved for patients with anti-AChR antibody-positive generalized refractory MG. Here, we report a Japanese man with MG who well responded to eculizumab, but experienced acute severe worsening of myasthenic symptoms 2 months after its discontinuation. Plasmapheresis did not improve his symptoms; hence, eculizumab was re-administered, resulting in a dramatic response within a week. This is an informative case because eculizumab discontinuation in patients with MG has been very rarely reported. If eculizumab treatment is clinically well effective and AChR antibody titer does not decrease, clinicians should be aware that acute and critical deterioration of MG may occur after the eculizumab discontinuation.

Identifiants

pubmed: 33068973
pii: S0165-5728(20)30685-8
doi: 10.1016/j.jneuroim.2020.577424
pii:
doi:

Substances chimiques

Antibodies, Monoclonal, Humanized 0
Autoantibodies 0
Complement Inactivating Agents 0
eculizumab A3ULP0F556

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

577424

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Auteurs

Akiyuki Uzawa (A)

Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan. Electronic address: auzawa@chiba-u.jp.

Yukiko Ozawa (Y)

Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.

Manato Yasuda (M)

Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.

Satoshi Kuwabara (S)

Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.

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Classifications MeSH