[Pubmed] Potential relationship between MuSK-MG and autologous hematopoietic stem cell transplantation: a case report

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Neuromuscul Disord. 2025 Jul 8;53:105444. doi: 10.1016/j.nmd.2025.105444. Online ahead of print.

ABSTRACT

A 61-year-old woman developed anti-muscle-specific tyrosine kinase antibody positive myasthenia gravis (MuSK-MG) three years after autologous hematopoietic stem cell transplantation (HSCT) for multiple myeloma. Symptoms improved following methylprednisolone pulse therapy, intravenous immunoglobulin, plasma exchange, and the addition of efgartigimod. A review of the literature revealed that all four previously reported cases of myasthenia gravis after autologous HSCT were MuSK-MG, although none were positive for anti-acetylcholine receptor (AChR) antibodies. This frequency differs significantly from the reported incidence of MuSK-MG in the general population and in patients following allogeneic HSCT, suggesting a potential association between autologous HSCT and MuSK-MG. Hypothesized mechanisms include a paraneoplastic mechanism and changes of IgG4 production following immune reconstitution after autologous HSCT. We suggest that clinicians should be aware of this possibility and consider MuSK-MG in the differential diagnosis of neurological symptoms that arise after autologous HSCT, even though autologous HSCT can be used as a therapeutic option for MuSK-MG.

PMID:40664087 | DOI:10.1016/j.nmd.2025.105444


Source: https://pubmed.ncbi.nlm.nih.gov/4066408 ... t9+e462414