V. I. Kravchenko, A. A. Chumak, K. M. Loganovsky, I. S. Diagil, V. F. Kuzmenko
State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Melnykova str., Kyiv, 04050, Ukraine
Myastenia and small doses of ionizing radiation: experience of successful use of rituximab for treatment of an irradiated with myasthenia gravis
A clinical case of the rituximab («Rituksim», «Mabthera») use to treat a man affected by the Chornobyl NPP accident with malignant resistant form of myasthenia gravis in conjunction with chronic mixed infection by Toxoplasma, Epstein-Barr virus, Cytomegalovirus and Herpes simplex virus is described. In the dynamics of two-year's observation the clinical efficacy of monoclonal antibodies was shown as the main symptoms stabilization and reducing doses of glucocorticoid and anticholinergic therapy. The positive effect was marked in the nearest and remote periods. Taking to account the efficacy, safety and good tolerability of rituximab, it is advisable to recommend treatment for people exposed to ionizing radiation and developing myasthenia associated with chronic mixed infection by Toxoplasma, Epstein-Barr, Cytomegalovirus and Herpes simplex virus.
Key words: myasthenia gravis, rituximab, monoclonal antibody, myasthenic crises, Chornobyl disaster, small doses of ionizing radiation, persistent infection.
Problems of radiation medicine and radiobiology. 2017;22:395–405.
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