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VOLUME 26 , ISSUE 6 ( June, 2022 ) > List of Articles

CASE REPORT

Myasthenia Gravis: An Unanticipated Cause of Failure to Wean in a Postpartum Patient with Preexisting Systemic Lupus Erythematosus

Abhiruchi Y Patki, Padmaja Durga, Alekhya Gangishetty, Tejasri Ketireddy, Naqiya Noorain

Keywords : Autoimmune diseases, Myasthenia, Weaning from mechanical ventilation

Citation Information : Patki AY, Durga P, Gangishetty A, Ketireddy T, Noorain N. Myasthenia Gravis: An Unanticipated Cause of Failure to Wean in a Postpartum Patient with Preexisting Systemic Lupus Erythematosus. Indian J Crit Care Med 2022; 26 (6):731-732.

DOI: 10.5005/jp-journals-10071-24228

License: CC BY-NC 4.0

Published Online: 20-06-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Sudden onset and de novo Myasthenia gravis (MG) in the presence of systemic lupus erythematosus (SLE) is a rare postpartum phenomenon and can easily misguide the treating physician. A known case of SLE, 4 days after an elective cesarean section, presented to the intensive care unit for weaning-off mechanical ventilation after being put on ventilatory support in the emergency room, following acute-onset partial seizures. She was subsequently diagnosed to have new-onset MG, treated for the condition and later successfully extubated.


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  1. Raut S, Reddy I, Sahi F, Masood A, Malik B. Association between systemic lupus erythematosus and myasthenia gravis: coincidence or sequelae? Cureus 2020;12(6):8422. DOI: 10.7759/cureus.8422.
  2. Nagarajan M, Maasila AT, Dhanapriya J, Dineshkumar T, Sakthirajan R, Rajasekar D, et al. Systemic lupus erythematosus and myasthenia gravis: a rare association. Indian J Nephrol 2019;29(1):62–64. DOI: 10.4103/ijn.IJN_12_18.
  3. Castrejón I, Shum K, Tseng CE, Askanase A. Association between myasthaenia gravis and systemic lupus erythematosus: Three case reports and review of the literature. Scand J Rheumatol 2011;40(6):486–490. DOI: 10.3109/03009742.2011.575077.
  4. Park MJ, Kim YA, Lee SS, Kim BC, Kim MK, Cho KH, et al. Appearance of systemic lupus erythematosus in patients with myasthenia gravis following thymectomy: two case reports. J Korean Med Sci 2004;19(1):134–136. DOI: 10.3346/jkms.2004.19.1.134.
  5. Sthoeger Z, Neiman A, Elbirt D, Zinger H, Magen E, Burstein R, et al. High prevalence of systemic lupus erythematosus in 78 myasthenia gravis patients: a clinical and serologic study. Am J Med Sci 2006;331(1):4–9. DOI: 10.1097/00000441-200601000-00004.
  6. Hostmann A, Jacobi AM, Mei H, Hiepe F, Dörner T. Peripheral B cell abnormalities and disease activity in systemic lupus erythematosus. Lupus 2008;17(12):1064–1069. DOI: 10.1177/0961203308095138.
  7. Singhal S, Baronia A, Gurjar M. Acute cardiogenic shock in a girl with systemic lupus erythematosus. Indian J Crit Care Med 2010;14(4): 209–211. DOI: 10.4103/0972-5229.76087.
  8. Gokhale A, Kimona A, Kantor S, Prakash S, Manhas Y. Posterior reversible leukoencephalopathy syndrome (PRES) in intensive care unit–Case series. Indian J Crit Care Med 2017;21(11):772–778. DOI: 10.4103/ijccm.IJCCM_235_17.
  9. Vinagre F, Santos MJ, Silva JC. Systemic lupus erythematosus with muscle weakness due to myasthenia gravis. Acta Reumatol Port 2006;31(2):167–172. PMID: 17058363.
  10. Sîrbu E, Milaş O, Petrica M, Petrica L. Systemic lupus erythematosus followed by myasthenia gravis: a rare association. Cent Eur J Med 2013;8(6):799–802. DOI: 10.2478/s11536-013-0239-5.
  11. McDonagh JE, Isenberg DA. Development of additional autoimmune diseases in a population of patients with systemic lupus erythematosus. Ann Rheum Dis 2000;59(3):230–232. DOI: 10.1136/ard.59.3.230.
  12. Jallouli M, Saadoun D, Eymard B, Leroux G, Haroche J, Le Thi Huong D, et al. The association of systemic lupus erythematosus and myasthenia gravis: a series of 17 cases, with a special focus on hydroxychloroquine use and a review of the literature. J Neurol 2012;259(7):1290–1297. DOI: 10.1007/s00415-011-6335-z.
  13. Boldingh MI, Maniaol A, Brunborg C, Weedon-Fekjaer H, Verschuuren J, Tallaksen C. Increased risk for clinical onset of myasthenia gravis during the postpartum period. Neurology 2016;87(20):2139–2145. DOI: 10.1212/WNL.0000000000003339.
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