u/Hells_angel1980

77 year old male patient 75 kgs, Myasthenia gravis, diagnosed in Feb 26. On decreasing steroids: Prednisone 30 mg x 1 month —> 20 mg x 1 month —> 10 mg x 1 month and increasing Azathioprine titrated upwards to 150 mg/day (2 mg/ day) on 9th April 2026.

Total leuckocytes, RBC count, platelets, neutrophils have remained stable, but lymphocytes have progressively reduced from 1100/ ml to 370/ ml.

Had a dental extraction yesterday to remove an infected tooth, but no other symptom.

What would you recommend re: azathioprine dosage for isolated lymphopenia ? Stop, reduce, continue?

Thank you

P.s. visiting a neurologist tomorrow, want to get views from the community as well

My father is 77yo. He got diagnosed with ocular Myasthenia gravis 3 months ago, which has now moved to include weakness in chewing.
- He is on Azathioprine (Imuran) 150 mg per day and Steroids (Prednisone) 10 mg per day.
- He has developed loss of appetite since last 1 month, which he attributes to reduced sense of taste.
- He is unable to taste salty food at all, where as his taste for sweet food is reduced. This is drastically reducing his oral intake.
- His sense of smell is preserved.

Has any of you experienced loss of taste? What was the underlying reason? How did you fix it?

Thank you

P.S. He has also developed severe central fatigue since last 1.5 months- individuals muscles don’t fatigue, but he feels extreme tiredness.