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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...

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Autores principales: Muralidhar Reddy, Y, B, Santhosh Kumar, Osman, Syed, Murthy, Jagarlapudi M K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
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.
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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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