[Eclizumab in the treatment of myasthenia gravis crisis complicating invasive thymoma: a case study of efficacy]

Rinsho Shinkeigaku. 2020 Dec 26;60(12):865-868. doi: 10.5692/clinicalneurol.cn-001483. Epub 2020 Nov 20.
[Article in Japanese]

Abstract

A 40-year-old male patient was diagnosed with invasive thymoma and myasthenia gravis in 2015. In 2016 and 2017, he experienced myasthenic crises, with an increase in size of invasive thymoma. In 2018, he received chemotherapy for the invasive thymoma. After 2 months, his symptoms rapidly progressed to myasthenic crisis with severe bulbar and respiratory symptoms, despite the significant effect of chemotherapy for the thymoma. High-dose corticosteroid, multiple plasma exchanges, and intravenous immunoglobulin did not improve the symptoms. Thus, eculizumab was administered, resulting in an improvement in his conditions. To our knowledge, this is the first report showing that eculizumab may improve myasthenic crisis with invasive thymoma.

Keywords: crisis; eculizumab; invasive thymoma; myasthenia gravis.

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Autoantibodies / blood
  • Biomarkers / blood
  • Disease Progression
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage
  • Male
  • Methylprednisolone / administration & dosage
  • Myasthenia Gravis / complications*
  • Myasthenia Gravis / diagnosis
  • Myasthenia Gravis / therapy*
  • Prednisolone / administration & dosage
  • Pulse Therapy, Drug
  • Receptors, Cholinergic / immunology
  • Thymectomy
  • Thymoma / complications*
  • Thymoma / diagnosis
  • Thymoma / therapy*
  • Thymus Neoplasms / complications*
  • Thymus Neoplasms / diagnosis
  • Thymus Neoplasms / therapy*
  • Tomography, X-Ray Computed

Substances

  • Antibodies, Monoclonal, Humanized
  • Autoantibodies
  • Biomarkers
  • Immunoglobulins, Intravenous
  • Receptors, Cholinergic
  • Prednisolone
  • eculizumab
  • Methylprednisolone