Transient Neonatal Myasthenia Gravis: Case Report

Sara Sitar, M. Treiber
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Abstract

Purpose: Transient neonatal myasthenia gravis (NMG) results from the transplacental transfer of antibodies of mothers with an autoimmune form of myasthenia gravis. The clinical presentation develops in 10%–20% of their children. This study aimed to present a case of a newborn with transient myasthenia gravis (MG) born to a mother diagnosed with MG. Case presentation: The disease manifested itself as generalized hypotonia, weak cry, respiratory distress, poor sucking, and facial diplegia. The symptoms were usually self-limiting, and transient supportive treatment was required. A diagnostic test was a good clinical response of the child to the administration of an acetylcholinesterase inhibitor. After the clearance of antibodies from the child's blood, long-term therapy was not necessary and the disease resolved. Treatment was supportive and included the administration of smaller and more frequent meals via a tube, noninvasive or invasive support of respiratory function, and use of acetylcholinesterase inhibitors (neostigmine and pyridostigmine). Conclusion: Pediatric patients diagnosed with transient NMG are extremely rare in everyday clinical practice, and hence it is important to be familiar with it.
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新生儿短暂性重症肌无力1例
目的:一过性新生儿重症肌无力(NMG)是由自身免疫性重症肌无力母亲的抗体经胎盘转移引起的。10%-20%的孩子会出现临床症状。本研究的目的是提出一个病例新生儿与短暂性重症肌无力(MG)出生的母亲诊断为MG。病例表现:全身性强直、弱哭、呼吸窘迫、吸吮不良、面部双瘫。这些症状通常是自限性的,需要短暂的支持治疗。诊断试验是一个很好的临床反应的儿童给予乙酰胆碱酯酶抑制剂。在清除儿童血液中的抗体后,不需要长期治疗,疾病得以解决。治疗是支持性的,包括通过插管给予更少和更频繁的进食,无创或有创呼吸功能支持,以及使用乙酰胆碱酯酶抑制剂(新斯的明和吡哆斯的明)。结论:在日常临床实践中,诊断为一过性NMG的儿科患者极为罕见,因此对其熟悉是很重要的。
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