Researchers from Macedonia presented a case of transient neonatal myasthenia gravis (TNMG) that was adequately managed—the symptoms of which disappeared.

The case illustrates the importance of a multidisciplinary approach when managing pregnant women with MG and their newborns.

The case involved the first child of a 29-year-old woman with myasthenia gravis (MG). The patient had had a thymectomy 2 years prior to her pregnancy and her condition was relatively stable during the pregnancy.

The baby was born at 38 weeks via Cesarean section and had mild hypotonia, poor crying, and weakened primitive reflexes.

Read more about the MG diagnosis

After 24 hours of birth, he was transferred to the neonatal intensive care unit and was treated with oxygen, and double antibiotic therapy was started. He had irregular breathing and tachydyspnea. 

Blood tests showed high antiacetylcholine receptor (AChR) antibodies and he was diagnosed with TNMG. He was treated with neostigmine and assisted mechanical ventilation until his antiAChR antibody titer was negative.

“A multidisciplinary approach in the management of pregnant women with MG and newborns through timely diagnosis and early appropriate treatment results in successful resolution of this condition,” the researchers concluded.

The case study is published in the journal Prilozi.

TNMG is a rare condition affecting infants who are born to mothers with MG. The condition can either be asymptomatic or cause severe respiratory distress, which can be fatal if not treated promptly.

A family history of MG, clinical presentation, and high antiAChR or antimuscle-specific kinase antibody titer are clear indicators of TNMG. Patients with TNMG are not at a higher risk of developing MG over the course of their life.

Reference

Ristovska S, Stomnaroska O, Dimitrioska R. Transient neonatal myasthenia gravis: a case report. Prilozi. Published online July 14, 2023. doi:10.2478/prilozi-2023-0036