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Primary CNS lymphoma complicating treatment of myasthenia gravis with mycophenolate mofetil

From the Department of Neurology (Dr. Vernino), University of Texas Southwestern Medical Center, Dallas; and Departments of Laboratory Medicine and Pathology (Dr. Salomao), Hematology (Dr. Habermann), and Neurology (Dr. O’Neill), Mayo Clinic, Rochester, MN.

Address correspondence and reprint requests to Dr. Steven Vernino, Department of Neurology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9036; e-mail: steven.vernino{at}utsouthwestern.edu

Mycophenolate mofetil (MM), an immunosuppressant used after organ transplantation, is also used for treatment of autoimmune myasthenia gravis (MG). A patient with generalized MG was effectively managed with MM but developed CNS lymphoma after 3 years of treatment. Primary CNS lymphoma regressed on withdrawal of MM. Despite minimal short-term side effects and apparent efficacy, chronic treatment of MG with MM may be associated with increased risk of lymphoproliferative disorders.

Disclosure: The authors report no conflicts of interest.

Received February 28, 2005. Accepted in final form April 18, 2005.

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