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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