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01-04-2022 | Myasthenia Gravis | COVID-19

Myasthenia gravis exacerbation and myasthenic crisis associated with COVID-19: case series and literature review

Authors: Cleonisio Leite Rodrigues, Hermany Capistrano de Freitas, Paulo Reges Oliveira Lima, Pedro Helder de Oliveira Junior, José Marcelino Aragão Fernandes, José Artur Costa D’Almeida, Paulo Ribeiro Nóbrega

Published in: Neurological Sciences | Issue 4/2022

Abstract

Background

Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction that can be exacerbated by many viral infections, including COVID-19. The management of MG exacerbations is challenging in this scenario. We report 8 cases of MG exacerbation or myasthenic crisis associated with COVID-19 and discuss prognosis and treatment based on a literature review.

Results

Most patients were female (7/8), with an average age of 47.1 years. Treatment was immunoglobulin (IVIG) in 3 patients, plasma exchange (PLEX) in 2 patients, and adjustment of baseline drugs in 3. In-hospital mortality was 25% and 37.5% in 2-month follow-up.

Discussion

This is the largest case series of MG exacerbation or myasthenic crisis due to COVID-19 to this date. Mortality was considerably higher than in myasthenic crisis of other etiologies. Previous treatment for MG or acute exacerbation treatment did not seem to interfere with prognosis, although sample size was too small to draw definitive conclusions. Further studies are needed to understand the safety and effectiveness of interventions in this setting, particularly of PLEX, IVIG, rituximab, and tocilizumab.

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Title: Myasthenia gravis exacerbation and myasthenic crisis associated with COVID-19: case series and literature review
Authors: Cleonisio Leite Rodrigues
Hermany Capistrano de Freitas
Paulo Reges Oliveira Lima
Pedro Helder de Oliveira Junior
José Marcelino Aragão Fernandes
José Artur Costa D’Almeida
Paulo Ribeiro Nóbrega
Publication date: 01-04-2022
Publisher: Springer International Publishing
Keywords: Myasthenia Gravis
Coronavirus
Rituximab
COVID-19
Rituximab
Published in: Neurological Sciences / Issue 4/2022
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-021-05823-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Myasthenia gravis exacerbation and myasthenic crisis associated with COVID-19: case series and literature review

Abstract

Background

Results

Discussion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Results

Discussion

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