title: Successful treatment of severe myasthenia gravis developed after allogeneic hematopoietic stem cell transplantation with plasma exchange and rituximab.
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.
authors.affiliation: Division of Pediatric Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Sule
authors.initials: S
authors.lastname: Unal
authors.forename: Erdal
authors.initials: E
authors.lastname: Sag
authors.forename: Baris
authors.initials: B
authors.lastname: Kuskonmaz
authors.forename: Selman
authors.initials: S
authors.lastname: Kesici
authors.forename: Benan
authors.initials: B
authors.lastname: Bayrakci
authors.forename: Deniz C
authors.initials: DC
authors.lastname: Ayvaz
authors.forename: Ilhan
authors.initials: I
authors.lastname: Tezcan
authors.forename: Dilek
authors.initials: D
authors.lastname: Yalnızoglu
authors.forename: Duygu
authors.initials: D
authors.lastname: Uckan
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000628:therapy; D006319:Hearing Loss, Sensorineural / Q000150:complications / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D009157:Myasthenia Gravis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D016116:Piebaldism / Q000150:complications / Q000628:therapy*; D010859:Pigmentation Disorders / Q000150:complications / Q000628:therapy*; D010951:Plasma Exchange; D012074:Remission Induction; D000069283:Rituximab; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D000069283:Rituximab; D016572:Cyclosporine; D009173:Mycophenolic Acid
keywords: Griscelli syndrome; bone marrow transplantation; graft-versus-host disease; myasthenia gravis; plasma exchange; rituximab