Pregnancy with Myasthenia Gravis
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Pregnancy, Myasthenia Gravis
Abstract
ABSTRACT
Myasthenia Gravis (MG) is a serious autoimmune disease, but now can be treated. Symptoms include weakness and fatigue in voluntary muscles caused by an autoantibody reaction to nicotinic acetylcholine receptor (AChR) at the post synapse of the neuromuscular junction. Pregnancy can affect autoimmune diseases so that pregnancy can aggravate MG disease. On the other hand it is also reported that pregnancy does not affect and can even improve MG disease. In this article, We report a 27-year-old woman who was diagnosed with myasthenia gravis that having a pregnancy. Initially she had no problems with pregnancy. Patients underwent pregnancy by taking the drug Mestinon four times daily and roborant. But entering the 33rd-34th week, the examination results showed that the pregnancy experienced oligohydramnios and Intrauterine Growth Retardation (IUGR), it was probably caused by malnutrition. Then we decided to end the patient's pregnancy with a Caesarean section. The operation went well, born to a baby boy / 2450grams / Apgar Score 5-7. Observation for one week the mother's condition continued to improve. Diplopia and weaknesses also improve. Likewise the baby showed a healthy condition. The patient was discharged while still taking MG drugs that had been previously consumed. This case report showed that pregnancy worsened MG disease, but MG did not affect pregnancy.
Keywords : Pregnancy, Myasthenia Gravis
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References
Bansal, R., Goyal, M. K., & Modi, M. (2018). Management of myasthenia gravis during pregnancy. Indian Journal of Pharmacology, 50(6), 302–308. https://doi.org/10.4103/ijp.IJP_452_17
Chaudhry, S. A., Vignarajah, B., & Koren, G. (2012). Myasthenia gravis during pregnancy. Canadian Family Physician Medecin de Famille Canadien, 58(12), 1346–1349. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23242891
Gilhus, N. E. (2016). Myasthenia Gravis. New England Journal of Medicine, 375(26), 2570–2581. https://doi.org/10.1056/NEJMra1602678
Hamel, J., & Ciafaloni, E. (2018). An Update: Myasthenia Gravis and Pregnancy. Neurologic Clinics, 36(2), 355–365. https://doi.org/10.1016/j.ncl.2018.01.005
Phillips, W. D., & Vincent, A. (2016). Pathogenesis of myasthenia gravis: update on disease types, models, and mechanisms. F1000Research, 5, 1513. https://doi.org/10.12688/f1000research.8206.1
Riemersma, S., Vincent, A., Beeson, D., Newland, C., Hawke, S., Vernet-der Garabedian, B., … Newsom-Davis, J. (1996). Association of arthrogryposis multiplex congenita with maternal antibodies inhibiting fetal acetylcholine receptor function. The Journal of Clinical Investigation, 98(10), 2358–2363. https://doi.org/10.1172/JCI119048
Schwendimann, R. N., Burton, E., & Minagar, A. (2005). Management of myasthenia gravis. American Journal of Therapeutics, 12(3), 262–268. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15891271
Téllez-Zenteno, J. F., Hernández-Ronquillo, L., Salinas, V., Estanol, B., & da Silva, O. (2004). Myasthenia gravis and pregnancy: clinical implications and neonatal outcome. BMC Musculoskeletal Disorders, 5(1), 42. https://doi.org/10.1186/1471-2474-5-42
Thanvi, B. R. (2004). Update on myasthenia gravis. Postgraduate Medical Journal, 80(950), 690–700. https://doi.org/10.1136/pgmj.2004.018903
Waters, J. (2019). Management of Myasthenia Gravis in Pregnancy. Neurologic Clinics, 37(1), 113–120. https://doi.org/10.1016/j.ncl.2018.09.003
Yi, J. S., Guptill, J. T., Stathopoulos, P., Nowak, R. J., & O’Connor, K. C. (2018). B cells in the pathophysiology of myasthenia gravis. Muscle & Nerve, 57(2), 172–184. https://doi.org/10.1002/mus.25973
Authors
Qanun Medika by FK UM Surabaya is liscence under Lisensi Creative Commons Atribusi 4.0 Internasional.