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

Objectives- To measure clinical and immunological parameters in a patient with myasthenia gravis (MG) treated with antibodies against tumour necrosis factor-alpha (infliximab, Remicade((R))). Patient and Methods- A patient with severe MG received repeated injections of infliximab. His muscle function score was monitored and the immunological parameters were followed using enzyme-linked immunosorbent assay, flow cytometry and radioimmunoassay. Results- The patient improved in muscle fatigability tests and the levels of antibodies against the acetylcholine receptor decreased during treatment. The activation marker human leucocyte antigen-DR on CD4(+) T cells also decreased. Conclusion- Treatment with infliximab might be beneficial for patients with severe MG but demands careful monitoring of possible serious side-effects.