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VOLUME 24 , ISSUE 1 ( January, 2020 ) > List of Articles

CASE REPORT

Successfully Treated Hepatitis B Positive Refractory Myasthenic Crisis with Rituximab

R Kumar Singh, Deepika Joshi, Shivani Rath

Keywords : Myasthenia gravis, Myasthenic crises, Rituximab

Citation Information : Singh RK, Joshi D, Rath S. Successfully Treated Hepatitis B Positive Refractory Myasthenic Crisis with Rituximab. Indian J Crit Care Med 2020; 24 (1):71-72.

DOI: 10.5005/jp-journals-10071-23320

License: CC BY-NC 4.0

Published Online: 01-01-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular transmission, which presents with fluctuating and variable weakness in ocular, bulbar, limb, and respiratory muscles resulting from an antibody-mediated, T-cell-dependent immunologic attack on the postsynaptic membrane of the neuromuscular junction. Although treatment of MG and myasthenic crisis is based on few specific principles, it is highly individualized. We report a successfully treated case of refractory myasthenic crisis who was on a ventilator for 7 months (210 days), perhaps the longest from India, and required multiple cycles of plasma exchange, intravenous immunoglobulin infusion, and one cycle of rituximab. It exemplifies the role of highly individualized therapy and interdisciplinary cooperation in management of refractory myasthenic crisis.


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