A clinical and immunological study of a myasthenia gravis patient treated with infliximab

Abstract

Treatment with infliximab might be beneficial for patients with severe MG but demands careful monitoring of possible serious side-effects.

Successful resolution of pneumonia developed in a patient affected by Crohn’s disease, rheumatoid arthritis, myasthenia gravis and recurrent uveitis during concomitant treatment with tumour necrosis factor α inhibitors and conventional immunosuppressive drugs

“…Only one case report showed the potential benefit coming from therapy with infliximab in one patient with myasthenia gravis, but the appearance of infectious side-effects, as in our patient, lead to withdrawal of this biological agent (6). To our knowledge this should be the first report of use of adalimumab in a patient with myasthenia gravis.…”

Widely varying TNF-α levels in patients with myasthenia gravis

“…Recent trials of infliximab and etanercept for MG patients have been encouraging [9][10][11], and both drugs are monoclonal antibodies that target TNF-a in the pathogenesis of MG. Infliximab ameliorated muscle function and antiAChR antibody level decreased in a patient with severe MG [9]. Six of eight patients with corticosteroid-response MG showed clinical improvement during etanercept treatment [10].…”

“…Six of eight patients with corticosteroid-response MG showed clinical improvement during etanercept treatment [10]. However, it is not clear from these studies that the level of TNF-a was associated with clinical status of patients: in the trial of etanercept, serum TNF-a levels varied widely at the start of the trial [10,11], and there was no mention of serum TNF-a level in the infliximab trial [9]. Likewise, our results showed that clinicians might not prescribe those medications on the basis of patients' serum TNF-a level.…”

Treatment of a patient with myasthenia gravis using antibodies against CD25

“…Surface staining of CD4, CD8, CD25, CD28, CD45RA, and CD45RO (all from BD Biosciences, Franklin Lakes, NJ, except CD45RO which was from DAKO A/S, Glostrup, Denmark) was performed according to a previously described method (9).…”