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Temporal association between SARS-CoV-2 and new-onset myasthenia gravis: is it causal or coincidental?
Several case reports of COVID-19 in patients with myasthenia gravis (MG) have been documented. However, new-onset autoimmune MG following COVID-19 has been reported very rarely. We report one such case here. A 65-year-old man presented to us with dysphagia 6 weeks following mild COVID-19. He was eva...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8296802/ https://www.ncbi.nlm.nih.gov/pubmed/34290032 http://dx.doi.org/10.1136/bcr-2021-244146 |
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author | Muralidhar Reddy, Y B, Santhosh Kumar Osman, Syed Murthy, Jagarlapudi M K |
author_facet | Muralidhar Reddy, Y B, Santhosh Kumar Osman, Syed Murthy, Jagarlapudi M K |
author_sort | Muralidhar Reddy, Y |
collection | PubMed |
description | Several case reports of COVID-19 in patients with myasthenia gravis (MG) have been documented. However, new-onset autoimmune MG following COVID-19 has been reported very rarely. We report one such case here. A 65-year-old man presented to us with dysphagia 6 weeks following mild COVID-19. He was evaluated and diagnosed as antiacetylcholine receptor antibody (AchR) positive, non-thymomatous, generalised MG. He subsequently developed myasthenic crisis and improved after treatment with intravenous immunoglobulin, prednisolone and pyridostigmine. Systematic literature review showed eight more similar cases. Analysis of all cases including the one reported here showed these features: mean age 55.8 years, male gender (5), time interval between COVID-19 and MG (5–56 days), generalised (5), bulbar and/or ocular symptoms (4), anti-AchR antibodies (7) and antimuscle-specific kinase antibodies (2). All have improved with immunotherapy. Although, many hypothesis are proposed to explain causal relationship between the two, it could as well be sheer coincidence. |
format | Online Article Text |
id | pubmed-8296802 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-82968022021-08-12 Temporal association between SARS-CoV-2 and new-onset myasthenia gravis: is it causal or coincidental? Muralidhar Reddy, Y B, Santhosh Kumar Osman, Syed Murthy, Jagarlapudi M K BMJ Case Rep Case Report Several case reports of COVID-19 in patients with myasthenia gravis (MG) have been documented. However, new-onset autoimmune MG following COVID-19 has been reported very rarely. We report one such case here. A 65-year-old man presented to us with dysphagia 6 weeks following mild COVID-19. He was evaluated and diagnosed as antiacetylcholine receptor antibody (AchR) positive, non-thymomatous, generalised MG. He subsequently developed myasthenic crisis and improved after treatment with intravenous immunoglobulin, prednisolone and pyridostigmine. Systematic literature review showed eight more similar cases. Analysis of all cases including the one reported here showed these features: mean age 55.8 years, male gender (5), time interval between COVID-19 and MG (5–56 days), generalised (5), bulbar and/or ocular symptoms (4), anti-AchR antibodies (7) and antimuscle-specific kinase antibodies (2). All have improved with immunotherapy. Although, many hypothesis are proposed to explain causal relationship between the two, it could as well be sheer coincidence. BMJ Publishing Group 2021-07-21 /pmc/articles/PMC8296802/ /pubmed/34290032 http://dx.doi.org/10.1136/bcr-2021-244146 Text en © BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ. https://bmj.com/coronavirus/usageThis article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained. |
spellingShingle | Case Report Muralidhar Reddy, Y B, Santhosh Kumar Osman, Syed Murthy, Jagarlapudi M K Temporal association between SARS-CoV-2 and new-onset myasthenia gravis: is it causal or coincidental? |
title | Temporal association between SARS-CoV-2 and new-onset myasthenia gravis: is it causal or coincidental? |
title_full | Temporal association between SARS-CoV-2 and new-onset myasthenia gravis: is it causal or coincidental? |
title_fullStr | Temporal association between SARS-CoV-2 and new-onset myasthenia gravis: is it causal or coincidental? |
title_full_unstemmed | Temporal association between SARS-CoV-2 and new-onset myasthenia gravis: is it causal or coincidental? |
title_short | Temporal association between SARS-CoV-2 and new-onset myasthenia gravis: is it causal or coincidental? |
title_sort | temporal association between sars-cov-2 and new-onset myasthenia gravis: is it causal or coincidental? |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8296802/ https://www.ncbi.nlm.nih.gov/pubmed/34290032 http://dx.doi.org/10.1136/bcr-2021-244146 |
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