How frequently do you check lab work in patients with stable myasthenia gravis?

It depends on what medications they are on!

• If patients are on pyridostigmine only (some mild ocular MG cases), none.
• If patients are on monotherapy with eculizumab or ravulizumab, I check none.
• On steroids: at least twice a year A1c, BMP, annual DEXA scan for osteoporosis, annual eye exam.
• On azathioprine, MMF or MTX: q3 months CBC, LFT, annual skin exam.
• On cyclosporine or tacrolimus: initially monthly levels and CMP, in a patient with long stability, can check every 3 months.
• On rituximab: pre-treatment hepatitis B serologies and quantiferon, while on rx, probably LFT annually and possibly checking immunoglobulin levels if rx continues for >2-3 years (some patients will become hypogammaglobulinemic).