title: [Fluoroquinolone associated myasthenia gravis exacerbation: clinical analysis of 9 cases].
abstract: OBJECTIVE
  To explore the characteristics of acute exacerbations of myasthenia gravis after fluoroquinolone exposure.
  
  
  METHODS
  Gender, age, prior type, absolute score, concurrent disease, precipitated disease, use of antibiotic, onset/symptom/degree of exacerbation, therapeutic measures and prognosis at Month 1 were retrospectively analyzed for 9 patients after fluoroquinolone systemic exposure.
  
  
  RESULTS
  Ciprofloxacin (n = 4), levofloxacin (n = 1) and moxifloxacin (n = 4) exposure resulted in myasthenia gravis exacerbation. Myasthenia gravis exacerbations developed at 15 minutes to 4 days post-exposure. And the clinical scores of quantitative myasthenia gravis (QMG) increased by an average of 10. The main syndromes included dyspnea, diplopia, ptosis and dysphagia. All patients improved upon the withdrawal of fluoroquinolone in conjunctions with other interventions.
  
  
  CONCLUSIONS
  Fluoroquinolone exposure may result in myasthenia gravis exacerbations in patients with underlying diseases. Healthcare professionals should be aware of this serious drug-disease association.
authors.affiliation: Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Shu-hui
authors.initials: SH
authors.lastname: Wang
authors.forename: Yan-chen
authors.initials: YC
authors.lastname: Xie
authors.forename: Bin
authors.initials: B
authors.lastname: Jiang
authors.forename: Jia-yue
authors.initials: JY
authors.lastname: Zhang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Qu
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhao
authors.forename: Yao
authors.initials: Y
authors.lastname: Li
authors.forename: Shan-shan
authors.initials: SS
authors.lastname: Qiao
authors.forename: Chun-ling
authors.initials: CL
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001372:Aza Compounds / Q000009:adverse effects / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D024841:Fluoroquinolones / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D064704:Levofloxacin / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D000077266:Moxifloxacin; D009157:Myasthenia Gravis / Q000139:chemically induced* / Q000188:drug therapy; D011804:Quinolines / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D002939:Ciprofloxacin; D064704:Levofloxacin; D000077266:Moxifloxacin