title: Opportunistic infections in myasthenia gravis treated with mycophenolate mofetil.
abstract: Mycophenolate mofetil (MMF) is used for immunosuppression in myasthenia gravis (MG). Although there are numerous data on associated infection and prophylaxis in transplant patients who are on MMF, data in MG remains lacking. We report two elderly seropositive MG patients who developed cytomegalovirus (CMV) enteritis and Epstein-Barr virus (EBV) encephalitis while on MMF for 5months and 1year, respectively. Chronic MMF therapy in MG patients may trigger life-threatening infections including CMV and EBV diseases, especially in the elderly. Similar to the practice in transplant patients, viral serology testing and appropriate prophylactic regimen with antiviral agents should be considered, particularly in older MG patients.
authors.affiliation: Neurological Institute, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA. Pichet.Termsarasab@uhhospitals.org
authors.forename: Pichet
authors.initials: P
authors.lastname: Termsarasab
authors.forename: Bashar
authors.initials: B
authors.lastname: Katirji
mesh_terms: D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000139:chemically induced / Q000188:drug therapy / Q000276:immunology; D018792:Encephalitis, Viral / Q000139:chemically induced / Q000188:drug therapy / Q000276:immunology; D004751:Enteritis / Q000139:chemically induced / Q000188:drug therapy / Q000276:immunology; D020031:Epstein-Barr Virus Infections / Q000139:chemically induced / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host / Q000187:drug effects* / Q000276:immunology; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D009157:Myasthenia Gravis / Q000188:drug therapy*; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D009894:Opportunistic Infections / Q000139:chemically induced* / Q000188:drug therapy / Q000276:immunology
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid