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NEUROLOGY 1986;36:1533
© 1986 American Academy of Neurology

Monitoring azathioprine therapy in myasthenia gravis

Arnold S. Witte, MD, David R. Cornblath, MD, Norman J. Schatz, MD and Robert P. Lisak, MD

University of Pennsylvania School of Medicine, Department of Neurology, Philadelphia, PA.

Azathioprine (AZA) is used increasingly in the treatment of selected patients with myasthenia gravis (MG). The "usual" dose is 2 to 3 mg/kg/d, but guidelines do not exist to determine a specific dose for an individual patient. We reviewed our previously reported MG patients to determine what laboratory studies correlated with therapeutic efficacy. Among the studies examined, red cell mean corpuscular volume (RBC MCV) was the most useful: in 10 patients who responded to AZA, MCV increased by 15 ± 2 fl (mean ± SD), while in 6 nonresponders, MCV increased by only 4.5 ± 6 fl (p ≤ 0.01). RBC MCV may be helpful in monitoring AZA therapy in patients with MG.

Address correspondence and reprint requests to Dr. Witte. Thomas Jefferson University Hospital, Suite 9606 New Hospital, III South Eleventh Street, Philadelphia, PA 19107.

Presented in part at the thirty-seventh annual meeting of the American Academy of Neurology, Dallas, TX, April 1985.

Accepted for publication March 5, 1986.




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