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She received a weekly plasma exchange (one day a week) via the Perma-cath. She continued her medications that included Prednisone 60 mg q day, Neoral 200 mg BID, Cellcept 500 mg BID, Mestinon 150 mg q 4h while awake and Levsin 0.125 mg q 4h while awake. The Prednisone was gradually reduced. Initially she required one plasma exchange per week. This was later changed to one plasma exchange every 2 weeks and then every 3 weeks. She continued to do well and was essentially asymptomatic. She has now undergone a thymectomy. Normal thymus was removed. She is now not getting plasma exchanges and continues on the following medications:
Cellcept 500 mg BID
Prednisone 20 mg qod
Neoral 200 mg BID
Mestinon 150 mg q 4h while awake
Levsin 0.125 with the Mestinon
(c) 2002 Medical College of Georgia
Modified 1/9/2002