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Successful early treatment with intravenous immunoglobulin for seronegative myasthenia gravis with onset during pregnancy: A case report
Kazuhiro Horiuchi*, Chika Sato, Takashi Odo andHideki Houzen
Version of Record online: 12 AUG 2016
Myasthenia gravis is an autoimmune disorder predominantly affecting women of reproductive age; its course during pregnancy is unpredictable. Here we report a case of a 34-year-old woman who developed myasthenia gravis during pregnancy. At 18 weeks of pregnancy, she started experiencing general fatigue and weakness when working. After examination, we diagnosed her with seronegative myasthenia gravis. Treatment included pyridostigmine (60 mg/day), oral prednisolone (5 mg, alternate day), intravenous immunoglobulin (0.4 mg/kg/day, 5 days) and methylprednisolone pulse therapy (500 mg/day, 3 days); her clinical response was good.
An uneventful vaginal delivery took place and the infant showed no signs of muscular weakness. Myasthenia gravis is a high-risk disease, particularly when associated with pregnancy. We suggest that early treatment with intravenous immunoglobulin is safe and effective for myasthenia gravis with pregnancy.