Neurology
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Published online before print October 25, 2006, doi:10.1212/01.wnl.0000247741.72466.8c)
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Received April 24, 2006
Accepted September 5, 2006

Myasthenia gravis exacerbation or unmasking associated with telithromycin treatment

X. Perrot MD*, N. Bernard PharmD, C. Vial MD, J. C. Antoine MD, PhD, H. Laurent MD, T. Vial MD, C. Confavreux MD, PhD, and S. Vukusic MD, PhD

From the Department of Neurology A (X.P., C.C., S.V.) and Department of Electromyography and Muscular Disorders (C.V.), Hôpital Neurologique, and Regional Pharmacovigilance Center (N.B., T.V.), Hospices Civils de Lyon; Department of Neurology (J.C.A.), Hôpital de Bellevue, Saint-Étienne; and Department of Internal Medicine (H.L.), Centre Hospitalier du Pays de Gier, Saint-Chamond, France.


* To whom correspondence should be addressed. E-mail: xavier.perrot{at}chu-lyon.fr.

Abstract-- Telithromycin, a new ketolide antibiotic, has been implicated in the exacerbation or unmasking of myasthenia gravis. This retrospective study presents two clinical reports and summarizes eight other suspected cases notified to the French pharmacovigilance system, highlighting a potentially life-threatening risk of telithromycin treatment in myasthenic patients. An important common feature was that, in seven cases, symptomatology occurred within 2 hours of first telithromycin intake--notably in cases of severe exacerbation.







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