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Table 1 Clinical characteristics of the patients

From: Myasthenia gravis exacerbation after melatonin administration: case series from a tertiary referral centre

Patient

Patient 1

Patient 2

Patient 3

Age (years)

49

87

35

Type of MG

Generalized

Generalized

Generalized

Antibodies

Double seronegative

Positive for anti-AchR

Positive for anti-AchR

Treatment

PDN 10 mg/48 h and

MA 360 mg/12 h

PDN 10 mg/48 h

PDN 10 mg/48 h and MA 540 mg/24 h

MGFA prior to taking melatonin

0

I

I

MGFA-PIS prior to taking melatonin

PR

MM1

MM3

ADL score prior to taking melatonin

0

0

2

Melatonin dose

1.95 mg/day

1.9 mg/day

1.95 mg/day

Time from start of melatonin to worsening

3 weeks

2 days

7 days

Deterioration in ADL score

5

4

7

Melatonin ceased

Yes

No

Yes

Treatment received

Increased dose of PDN

Increased dose of PDN

Increased dose of PDN plus IVIG

Time from cessation of melatonin to improvement

5 weeks

6 weeks

  1. MG myasthenia gravis, anti-AchR antibodies against the acetylcholine receptor, PDN prednisone, MA mycophenolic acid, IVIG intravenous immunoglobulins, MGFA Myasthenia Gravis Foundation of America Clinical Classification, MGFA-PIS Myasthenia Gravis Foundation of America Post-Intervention Status, PR Pharmacological Remission, MM Minimal Manifestations, ADL Activities of Daily Living Profile