{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T16:38:34Z","timestamp":1775579914826,"version":"3.50.1"},"reference-count":33,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jns-journal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of the Neurological Sciences"],"published-print":{"date-parts":[[2022,11]]},"DOI":"10.1016\/j.jns.2022.120394","type":"journal-article","created":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T21:03:37Z","timestamp":1661807017000},"page":"120394","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":10,"special_numbering":"C","title":["A single low-dose rituximab infusion in severe chronic refractory myasthenia gravis in resource-limited settings"],"prefix":"10.1016","volume":"442","author":[{"given":"Jeannine M.","family":"Heckmann","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.jns.2022.120394_bb0005","first-page":"255","article-title":"Clinical characteristics of refractory myasthenia gravis patients","volume":"86","author":"Suh","year":"2013","journal-title":"Yale. J. Biol. Med."},{"key":"10.1016\/j.jns.2022.120394_bb0010","doi-asserted-by":"crossref","DOI":"10.1177\/1756285617749134","article-title":"When myasthenia gravis is deemed refractory: clinical signposts and treatment strategies","volume":"11","author":"Mantegazza","year":"2018","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"10.1016\/j.jns.2022.120394_bb0015","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1002\/mus.20479","article-title":"Successful treatment of MuSK antibody positive myasthenia gravis with rituximab","volume":"33","author":"Hain","year":"2006","journal-title":"Muscle Nerve"},{"key":"10.1016\/j.jns.2022.120394_bb0020","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1007\/s00415-006-0442-2","article-title":"Rituximab in refractory MuSK antibody myasthenia gravis","volume":"254","author":"Thakre","year":"2007","journal-title":"J. Neurol."},{"key":"10.1016\/j.jns.2022.120394_bb0025","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1212\/WNL.0b013e3182407982","article-title":"Long-lasting treatment effect of rituximab in MuSK myasthenia","volume":"78","author":"Diaz-Manera","year":"2012","journal-title":"Neurology"},{"key":"10.1016\/j.jns.2022.120394_bb0030","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1177\/1756285611411503","article-title":"Response of patients with refractory myasthenia gravis to rituximab: a retrospective study","volume":"4","author":"Nowak","year":"2011","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"10.1016\/j.jns.2022.120394_bb0035","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1002\/mus.25597","article-title":"Rituximab treatment of myasthenia gravis: a systematic review","volume":"56","author":"Tandan","year":"2017","journal-title":"Muscle Nerve"},{"key":"10.1016\/j.jns.2022.120394_bb0040","doi-asserted-by":"crossref","DOI":"10.1016\/j.jns.2020.116690","article-title":"Differential response to rituximab in anti-AChR and anti-MuSK positive myasthenia gravis patients: a single-center retrospective study","volume":"411","author":"Litchman","year":"2020","journal-title":"J. Neurol. Sci."},{"key":"10.1016\/j.jns.2022.120394_bb0045","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.jneuroim.2017.05.021","article-title":"Responsiveness to low-dose rituximab in refractory generalized myasthenia gravis","volume":"311","author":"Jing","year":"2017","journal-title":"J. Neuroimmunol."},{"key":"10.1016\/j.jns.2022.120394_bb0050","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1001\/jamaneurol.2020.0851","article-title":"Comparison between rituximab treatment for new-onset generalized myasthenia gravis and refractory generalized myasthenia gravis","volume":"77","author":"Brauner","year":"2020","journal-title":"JAMA Neurol."},{"key":"10.1016\/j.jns.2022.120394_bb0055","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1002\/acn3.314","article-title":"Rituximab in refractory myasthenia gravis: a prospective, open-label study with long-term follow-up","volume":"3","author":"Anderson","year":"2016","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"10.1016\/j.jns.2022.120394_bb0060","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1212\/WNL.55.1.16","article-title":"Myasthenia gravis: recommendations for clinical research standards. Task force of the medical scientific advisory Board of the Myasthenia Gravis Foundation of America","volume":"55","author":"Jaretzki","year":"2000","journal-title":"Neurology"},{"key":"10.1016\/j.jns.2022.120394_bb0065","article-title":"Phase 2 trial of rituximab in acetylcholine receptor antibody-positive generalized myasthenia gravis: the BeatMG study","author":"Nowak","year":"2021","journal-title":"Neurology"},{"key":"10.1016\/j.jns.2022.120394_bb0070","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1007\/s00415-019-09191-6","article-title":"High efficacy of rituximab for myasthenia gravis: a comprehensive nationwide study in Austria","volume":"266","author":"Topakian","year":"2019","journal-title":"J. Neurol."},{"key":"10.1016\/j.jns.2022.120394_bb0075","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1136\/jnnp.2010.220475","article-title":"Use and monitoring of low dose rituximab in myasthenia gravis","volume":"82","author":"Blum","year":"2011","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"10.1016\/j.jns.2022.120394_bb0080","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1016\/j.nmd.2007.07.002","article-title":"Myasthenia gravis in south Africans: racial differences in clinical manifestations","volume":"17","author":"Heckmann","year":"2007","journal-title":"Neuromuscul. Disord."},{"key":"10.1016\/j.jns.2022.120394_bb0085","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1002\/mus.25154","article-title":"Characteristics of acetylcholine-receptor-antibody-negative myasthenia gravis in a south African cohort","volume":"54","author":"Huda","year":"2016","journal-title":"Muscle Nerve"},{"key":"10.1016\/j.jns.2022.120394_bb0090","doi-asserted-by":"crossref","first-page":"775","DOI":"10.3389\/fneur.2020.00775","article-title":"Management issues in myasthenia gravis patients living with HIV: a case series and literature review","volume":"11","author":"Heckmann","year":"2020","journal-title":"Front. Neurol."},{"key":"10.1016\/j.jns.2022.120394_bb0095","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1212\/WNL.0000000000002790","article-title":"International consensus guidance for management of myasthenia gravis: executive summary","volume":"87","author":"Sanders","year":"2016","journal-title":"Neurology"},{"key":"10.1016\/j.jns.2022.120394_bb0100","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/nyas.13471","article-title":"A unique subphenotype of myasthenia gravis","volume":"1412","author":"Heckmann","year":"2018","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"10.1016\/j.jns.2022.120394_bb0105","doi-asserted-by":"crossref","DOI":"10.1212\/NXI.0000000000000463","article-title":"Monitoring B-cell repopulation after depletion therapy in neurologic patients","volume":"5","author":"Ellwardt","year":"2018","journal-title":"Neurol. Neuroimmunol. Neuroinflamm."},{"key":"10.1016\/j.jns.2022.120394_bb0110","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2022.834212","article-title":"The epidemiology and phenotypes of ocular manifestations in childhood and juvenile myasthenia gravis: a review","volume":"13","author":"Heckmann","year":"2022","journal-title":"Front. Neurol."},{"key":"10.1016\/j.jns.2022.120394_bb0115","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1002\/mus.26172","article-title":"Myasthenic ophthalmoparesis: time to resolution after initiating immune therapies","volume":"58","author":"Europa","year":"2018","journal-title":"Muscle Nerve"},{"key":"10.1016\/j.jns.2022.120394_bb0120","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1002\/mus.27233","article-title":"Short-term effect of low-dose rituximab on myasthenia gravis with muscle-specific tyrosine kinase antibody","volume":"63","author":"Zhou","year":"2021","journal-title":"Muscle Nerve"},{"key":"10.1016\/j.jns.2022.120394_bb0125","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1002\/mus.26790","article-title":"Low-dose rituximab every 6 months for the treatment of acetylcholine receptor-positive refractory generalized myasthenia gravis","volume":"61","author":"Lu","year":"2020","journal-title":"Muscle Nerve"},{"issue":"3","key":"10.1016\/j.jns.2022.120394_bb0130","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1212\/WNL.0000000000011124","article-title":"International consensus guidance for Management of Myasthenia Gravis: 2020 update","volume":"96","author":"Narayanaswami","year":"2021","journal-title":"Neurology"},{"key":"10.1016\/j.jns.2022.120394_bb0135","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1186\/1471-2377-11-97","article-title":"A single-blinded trial of methotrexate versus azathioprine as steroid-sparing agents in generalized myasthenia gravis","volume":"11","author":"Heckmann","year":"2011","journal-title":"BMC Neurol."},{"key":"10.1016\/j.jns.2022.120394_bb0140","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1002\/mus.10133","article-title":"Use of intravenous pulsed cyclophosphamide in severe, generalized myasthenia gravis","volume":"26","author":"De Feo","year":"2002","journal-title":"Muscle Nerve"},{"key":"10.1016\/j.jns.2022.120394_bb0145","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1136\/jnnp-2021-328665","article-title":"Eculizumab versus rituximab in generalised myasthenia gravis","volume":"93","author":"Nelke","year":"2022","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"10.1016\/j.jns.2022.120394_bb0150","article-title":"Anti-CD20 therapies in pregnancy and breast feeding: a review and ABN guidelines","author":"Dobson","year":"2022","journal-title":"Pract. Neurol."},{"key":"10.1016\/j.jns.2022.120394_bb0155","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1002\/mus.26876","article-title":"Rituximab in late-onset myasthenia gravis is safe and effective","volume":"62","author":"Sahai","year":"2020","journal-title":"Muscle Nerve"},{"key":"10.1016\/j.jns.2022.120394_bb0160","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1002\/mus.26156","article-title":"Rituximab in refractory myasthenia gravis: extended prospective study results","volume":"58","author":"Beecher","year":"2018","journal-title":"Muscle Nerve"},{"key":"10.1016\/j.jns.2022.120394_bb0165","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1136\/practneurol-2018-001899","article-title":"Rituximab in neurological disease: principles, evidence and practice","volume":"19","author":"Whittam","year":"2019","journal-title":"Pract. Neurol."}],"container-title":["Journal of the Neurological Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022510X22002568?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022510X22002568?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T16:00:11Z","timestamp":1758384011000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0022510X22002568"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11]]},"references-count":33,"alternative-id":["S0022510X22002568"],"URL":"https:\/\/doi.org\/10.1016\/j.jns.2022.120394","relation":{},"ISSN":["0022-510X"],"issn-type":[{"value":"0022-510X","type":"print"}],"subject":[],"published":{"date-parts":[[2022,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"A single low-dose rituximab infusion in severe chronic refractory myasthenia gravis in resource-limited settings","name":"articletitle","label":"Article Title"},{"value":"Journal of the Neurological Sciences","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jns.2022.120394","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 Elsevier B.V. All rights reserved.","name":"copyright","label":"Copyright"}],"article-number":"120394"}}