{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:27:49Z","timestamp":1791912469823,"version":"4.3.4"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,6]]},"DOI":"10.1097\/cnd.0000000000000034","type":"journal-article","created":{"date-parts":[[2014,5,27]],"date-time":"2014-05-27T02:36:33Z","timestamp":1401158193000},"page":"167-178","source":"Crossref","is-referenced-by-count":132,"title":["Treatment-Refractory Myasthenia Gravis"],"prefix":"10.1097","volume":"15","author":[{"given":"Nicholas J.","family":"Silvestri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gil I.","family":"Wolfe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-7-20210126","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1159\/000279334","article-title":"The incidence of myasthenia gravis: a systematic literature review.","volume":"34","author":"McGrogan","year":"2010","journal-title":"Neuroepidemiology"},{"key":"R2-7-20210126","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/CND.0b013e318137a24b","article-title":"Clinical review of muscle-specific tyrosine kinase-antibody positive myasthenia gravis.","volume":"8","author":"Wolfe","year":"2007","journal-title":"J Clin Neuromuscl Dis"},{"key":"R3-7-20210126","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1002\/mus.20498","article-title":". Repetitive nerve stimulation of facial muscles in MuSK antibody-positive myasthenia gravis.","volume":"33","author":"Oh","year":"2006","journal-title":"Muscle Nerve"},{"key":"R4-7-20210126","doi-asserted-by":"crossref","first-page":"1978","DOI":"10.1212\/01.WNL.0000065882.63904.53","article-title":". Clinical aspects of MuSK antibody positive seronegative MG.","volume":"60","author":"Sanders","year":"2003","journal-title":"Neurology"},{"key":"R5-7-20210126","doi-asserted-by":"crossref","first-page":"2304","DOI":"10.1093\/brain\/awg223","article-title":". Clinical correlates with anti-MuSK antibodies in generalized seronegative myasthenia gravis.","volume":"126","author":"Evoli","year":"2003","journal-title":"Brain"},{"key":"R6-7-20210126","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1111\/j.1468-1331.2005.01137.x","article-title":"Seronegative myasthenia gravis: disease severity and prognosis.","volume":"12","author":"Romi","year":"2005","journal-title":"Eur J Neurol"},{"key":"R7-7-20210126","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1055\/s-0032-1329200","article-title":"Myasthenia gravis.","volume":"32","author":"Silvestri","year":"2012","journal-title":"Semin Neurol"},{"key":"R8-7-20210126","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1002\/mus.21533","article-title":". Clinical findings in MuSK-antibody positive myasthenia gravis: a U.S. experience.","volume":"41","author":"Pasnoor","year":"2010","journal-title":"Muscle Nerve"},{"key":"R9-7-20210126","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1212\/01.wnl.0000254620.45529.97","article-title":". Clinical comparison of anti-MuSK- vs anti-AChR-positive and seronegative myasthenia gravis.","volume":"68","author":"Deymeer","year":"2007","journal-title":"Neurology"},{"key":"R10-7-20210126","first-page":"305","article-title":"Hong R, et al..","volume":"1132","author":"Drachman","year":"2008","journal-title":"Rebooting the immune system with high-dose cyclophosphamide for treatment of refractory myasthenia gravis Ann N Y Acad Sci"},{"key":"R11-7-20210126","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1002\/mus.21521","article-title":". Rituximab in the management of refractory myasthenia gravis.","volume":"41","author":"Zebardast","year":"2010","journal-title":"Muscle Nerve"},{"key":"R12-7-20210126","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":"R13-7-20210126","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1093\/annonc\/mdg175","article-title":"An overview of the current clinical use of the anti-CD20 antibody rituximab.","volume":"14","author":"Boye","year":"2003","journal-title":"Ann Oncol"},{"key":"R14-7-20210126","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.autrev.2009.08.007","article-title":". Current status on B-cell depletion therapy in autoimmune diseases other than rheumatoid arthritis.","volume":"9","author":"Dorner","year":"2009","journal-title":"Autoimmun Rev"},{"key":"R15-7-20210126","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1212\/WNL.55.7.1062-a","article-title":". Rituximab for myasthenia developing after bone marrow transplant.","volume":"55","author":"Zaja","year":"2000","journal-title":"Neurology"},{"key":"R16-7-20210126","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1136\/jnnp.2006.093567","article-title":"Complete remission induced by rituximab in seronegative, muscle-specific, kinase-positive myasthenia gravis.","volume":"78","author":"Baek","year":"2007","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R17-7-20210126","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1002\/ajh.20169","article-title":"Response of myasthenia gravis to rituximab in a patient with non-Hodgkin lymphoma.","volume":"77","author":"Gajra","year":"2004","journal-title":"Am J Hematol"},{"key":"R18-7-20210126","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":"R20-7-20210126","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1002\/mus.21047","article-title":"Improvement with rituximab in a patient with both rheumatoid arthritis and myasthenia gravis.","volume":"38","author":"Kerkeni","year":"2008","journal-title":"Muscle Nerve"},{"key":"R21-7-20210126","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1111\/j.1468-1331.2008.02399.x","article-title":". Successful treatment of refractory myasthenia gravis with rituximab.","volume":"16","author":"Lebrun","year":"2009","journal-title":"Eur J Neurol"},{"key":"R22-7-20210126","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1002\/mus.23412","article-title":". Rituximab in refractory and non-refractory myasthenia: a retrospective multicenter trial.","volume":"46","author":"Collongues","year":"2012","journal-title":"Muscle Nerve"},{"key":"R23-7-20210126","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":"R24-7-20210126","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.jns.2009.02.357","article-title":". Rituximab for myasthenia gravis: three case reports and review of the literature.","volume":"280","author":"Stieglbauer","year":"2009","journal-title":"J Neurol Sci"},{"key":"R25-7-20210126","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":"R26-7-20210126","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1067\/S0022-3476(03)00300-7","article-title":". Successful treatment of refractory myasthenia gravis using rituximab: a pediatric case report.","volume":"143","author":"Wylam","year":"2003","journal-title":"J Pediatr"},{"key":"R27-7-20210126","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":"R28-7-20210126","doi-asserted-by":"crossref","first-page":"4834","DOI":"10.1182\/blood-2008-10-186999","article-title":". Progressive multifocal leukoencephalopathy after rituximab therapy in HIV-negative patients: a report of 57 cases from the Research on Adverse Drug Events and Reports project.","volume":"113","author":"Carson","year":"2009","journal-title":"Blood"},{"key":"R29-7-20210126","first-page":"84","article-title":". Repeated treatment with high dose cyclophosphamide for severe autoimmune diseases.","volume":"3","author":"Dezern","year":"2013","journal-title":"Am J Blood Res"},{"key":"R30-7-20210126","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1002\/ana.10400","article-title":"Treatment of refractory myasthenia: rebooting with high-dose cyclophosphamide.","volume":"53","author":"Drachman","year":"2003","journal-title":"Ann Neurol"},{"key":"R31-7-20210126","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":"R32-7-20210126","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1136\/jnnp.2003.019232","article-title":". High dose cyclophosphamide for severe refractory myasthenia gravis.","volume":"75","author":"Gladstone","year":"2004","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R33-7-20210126","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1016\/0145-2126(85)90072-4","article-title":"4-Hydroperoxycyclophosphamide inhibits proliferation by human granulocyte-macrophage colony-forming cells (GM-CFC) but spares more primitive progenitor cells.","volume":"9","author":"Gordon","year":"1985","journal-title":"Leuk Res"},{"key":"R34-7-20210126","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1038\/nbt1344","article-title":". Discovery and development of the complement inhibitor eculizumab for the treatment of paroxysmal nocturnal hemoglobinuria.","volume":"25","author":"Rother","year":"2007","journal-title":"Nat Biotechnol"},{"key":"R35-7-20210126","doi-asserted-by":"crossref","first-page":"2843","DOI":"10.1172\/JCI29894","article-title":"Myasthenia gravis: past, present, and future.","volume":"116","author":"Conti-Fine","year":"2006","journal-title":"J Clin Invest"},{"key":"R36-7-20210126","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.jneuroim.2004.08.002","article-title":". The role of complement in myasthenia gravis: serological evidence of complement consumption in vivo.","volume":"158","author":"Romi","year":"2005","journal-title":"J Neuroimmunol"},{"key":"R37-7-20210126","doi-asserted-by":"crossref","first-page":"177","DOI":"10.3181\/00379727-105-26050","article-title":"Changes in serum complement activity in patients with myasthenia gravis.","volume":"105","author":"Nastuk","year":"1960","journal-title":"Proc Soc Exp Biol Med"},{"key":"R38-7-20210126","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1002\/mus.21398","article-title":". Correlation of C3 level with severity of generalized myasthenia gravis.","volume":"40","author":"Liu","year":"2009","journal-title":"Muscle Nerve"},{"key":"R39-7-20210126","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1084\/jem.147.4.973","article-title":". Role of complement in the pathogenesis of experimental autoimmune myasthenia gravis.","volume":"147","author":"Lennon","year":"1978","journal-title":"J Exp Med"},{"key":"R40-7-20210126","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1002\/mus.23839","article-title":". A randomized, double-blind, placebo-controlled phase II study of eculizumab in patients with refractory generalized myasthenia gravis.","volume":"48","author":"Howard","year":"2013","journal-title":"Muscle Nerve"},{"key":"R41-7-20210126","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1212\/WNL.41.6.923","article-title":". Repeat thymectomy in chronic myasthenia gravis.","volume":"41","author":"Miller","year":"1991","journal-title":"Neurology"},{"key":"R42-7-20210126","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1111\/j.1749-6632.1993.tb22945.x","article-title":". How reliable are imaging procedures in detecting residual thymus after previous thymectomy.","volume":"681","author":"Kornfield","year":"1993","journal-title":"Ann N Y Acad Sci"},{"key":"R43-7-20210126","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1016\/S0003-4975(00)01566-6","article-title":". Thoracoscopic completion thymectomy in patients with refractory nonthymomatous myasthenia.","volume":"70","author":"Pompeo","year":"2000","journal-title":"Ann Thorac Surg"},{"key":"R44-7-20210126","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.icvts.2004.02.008","article-title":". Extended rethymectomy in the treatment of refractory myasthenia gravis: original video-assisted technique of resternotomy and results of the treatment in 21 patients.","volume":"3","author":"Zielinski","year":"2004","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"R45-7-20210126","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1001\/archneurol.2009.28","article-title":"Allogeneic hematopoietic cell transplantation for refractory myasthenia gravis.","volume":"66","author":"Strober","year":"2009","journal-title":"Arch Neurol"},{"key":"R46-7-20210126","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1111\/j.1600-0404.1997.tb00279.x","article-title":". Myasthenia gravis after allogeneic bone marrow transplantation: a case report and review of the literature.","volume":"96","author":"Zaja","year":"1997","journal-title":"Acta Neurol Scand"},{"key":"R47-7-20210126","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.jns.2003.09.016","article-title":". Treatment and outcome of myasthenia gravis: retrospective multi-center analysis of 470 Japanese patients, 1999-2000.","volume":"224","author":"Kawaguchi","year":"2004","journal-title":"J Neurol Sci"}],"container-title":["Journal of Clinical Neuromuscular Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/CND.0000000000000034","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T20:24:44Z","timestamp":1621887884000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00131402-201406000-00007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,6]]},"references-count":46,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2014]]}},"URL":"https:\/\/doi.org\/10.1097\/cnd.0000000000000034","relation":{},"ISSN":["1522-0443"],"issn-type":[{"value":"1522-0443","type":"print"}],"subject":[],"published":{"date-parts":[[2014,6]]}}}