A Difficult Case of Myasthenia Gravis


Michael H. Rivner, M.D.


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Follow-up on this patient:

    She received a weekly plasma exchange (one day a week) via the Perma-cath.  She continued her medications that included Prednisone 60 mg q day, Neoral 200 mg BID, Cellcept 500 mg BID, Mestinon 150 mg q 4h while awake and Levsin 0.125 mg q 4h while awake.  The Prednisone was gradually reduced.  Initially she required one plasma exchange per week.  This was later changed to one plasma exchange every 2 weeks and then every 3 weeks.  She continued to do well and was essentially asymptomatic.   She has now undergone a thymectomy.  Normal thymus was removed.  She is now not getting plasma exchanges and continues on the following medications:

            Cellcept 500 mg BID

            Prednisone 20 mg qod

            Neoral 200 mg BID

            Mestinon 150 mg q 4h while awake

            Levsin 0.125 with the Mestinon

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(c) 2010 Medical College of Georgia

Modified 9/4/2010