title: Treatment-refractory myasthenia gravis.
abstract: Myasthenia gravis (MG) is the most common disorder of neuromuscular transmission and is a prototypical autoimmune disorder. Most patients with MG are successfully treated with acetylcholinesterase inhibitors, corticosteroids, and/or steroid sparing agents such as azathioprine and mycophenolate mofetil. There is a small subset of patients, however, with treatment-refractory disease. In these cases, medications such as rituximab, high-dose cyclophosphamide, and eculizumab may be used. Thymectomy (in some cases repeat thymectomy) is another option in selected patients. Studies evaluating these and other forms of therapy in treatment-refractory MG are reviewed.
authors.affiliation: Department of Neurology, State University of New York, Buffalo School of Medicine and Biomedical Sciences, Buffalo General Medical Center, Buffalo, NY.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Silvestri
authors.forename: Gil I
authors.initials: GI
authors.lastname: Wolfe
mesh_terms: D016026:Bone Marrow Transplantation; D004351:Drug Resistance; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D009157:Myasthenia Gravis / Q000188:drug therapy / Q000628:therapy*; D013934:Thymectomy
chemical_list: D007166:Immunosuppressive Agents