Primary CNS lymphoma complicating treatment of myasthenia gravis with mycophenolate mofetil.
Mycophenolate mofetil (MM), an immunosuppressant used after organ transplantation, is also used for treatment of autoimmune myasthenia gravis (MG). A patient with generalized MG was effectively managed with MM but developed CNS lymphoma after 3 years of treatment. Primary CNS lymphoma regressed on withdrawal of MM. Despite minimal short-term side effects and apparent efficacy, chronic treatment of MG with MM may be associated with increased risk of lymphoproliferative disorders.
Vernino
Steven
S
Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9036, USA. steven.vernino@utsouthwestern.edu
Salomao
Diva R
DR
Habermann
Thomas M
TM
O'Neill
Brian P
BP
D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000139:chemically induced* / Q000188:drug therapy / Q000276:immunology; D002471:Cell Transformation, Neoplastic / Q000187:drug effects / Q000276:immunology; D004359:Drug Therapy, Combination; D005260:Female; D005625:Frontal Lobe / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects / Q000276:immunology; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016393:Lymphoma, B-Cell / Q000139:chemically induced* / Q000188:drug therapy / Q000276:immunology; D008279:Magnetic Resonance Imaging; D009157:Myasthenia Gravis / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D010296:Parietal Lobe / Q000473:pathology / Q000503:physiopathology; D011241:Prednisone / Q000627:therapeutic use; D011729:Pyridostigmine Bromide / Q000627:therapeutic use; D000069283:Rituximab; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D000069283:Rituximab; D009173:Mycophenolic Acid; D011729:Pyridostigmine Bromide; D011241:Prednisone