First Post of Myasthenia Gravis Blog

.Sunday August 17, 2025 was the day before I tested positive  for Covid-19.  I tested positive on September 1,  12 days later.   On or about August 28,  I developed diplopia or double-vision.   On September 2,  I went to Mass Eye and Ear.  They did an MRI of my brain and found no tumors or anything else to explain the diplopia.  On Sunday,  September 7,  I felt very strange and went to the emergency room at MGH.   Antibody tests ordered by neurologists and clinical signs pointed to a diagnosis of Myasthenia Gravis.  Since only my eyes were affected,  it's called "ocular" MG.   I started a medication called pyridostigmine which is an acetylcholine esterase inhibitor.   Since MG is an autoimmune disease the targets the acetylcholine receptor on the muscle side of the neuro-muscular junction,  the idea is to increase the amount of ACh in the synapse.  Thus perhaps compensating for the lack of receptors.  In any case,  the drug did very little for my diplopia.  

On October 10,  I met with neurologist at the MGH neuromuscular clinic.  She put me on a course of prednisone up to 20mg per day.  After a few days my diplopia completely disappeared - great!.  However, there is a catch - long term use of prednisone is risky to bones.  Tomorrow, October 29, I start another drug which seems just as risky -  the brand name is Cellcept -  the drug is mycophenolate ,  a prodrug of mycophenolic acid. Mycophenolic acid's primary function is to block the proliferation of lymphocytes (T- and B-cells), which are crucial for the body's immune response.  It does this by non-competitively and reversibly inhibiting an enzyme called inosine monophosphate dehydrogenase (IMPDH).  This drug has many side effects but is seemingly less bad than prednisone -  we shall see.    more to come...


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