Pregnancy in Seronegative Myasthenia Gravis: A Single-Center Case Series

Abstract

Introduction: The course of double-seronegative myasthenia gravis (DSNMG) during and after pregnancy has not been well described. Objective: To assess the course of DSNMG during pregnancy and within 6 months postpartum. Methods: A retrospective cohort study of women with DSNMG seen in the Duke Myasthenia gravis (MG) Clinic after 2003. Results: Review of the Duke MG Clinic Registry and electronic medical record identified 8 patients who became pregnant after MG onset; the mean age at disease onset was 17.6 (SD = 10.0) years. Increased MG symptoms were observed in the first and third trimester and, most commonly, postpartum in 6 of 18 pregnancies. Except for 1 infant who developed respiratory distress that required neonatal intensive care admission, all the newborns were healthy at birth. Conclusions: As in seropositive MG, increased MG symptoms during pregnancy and within 6 months postpartum is also seen in women with DSNMG.

Comparing Seropositive and Seronegative Myasthenia During Pregnancy Requires Appropriate Design and Diagnostic Testing

“…We read with interest the article by Harada et al 1 about a series of 8 pregnant women with seronegative myasthenia gravis who were examined for the influence of pregnancy or puerperium on the severity of myasthenia. It was found that the number of myasthenia symptoms increased during the first and third trimester but most often after birth in 6 of 18 pregnancies.…”

“…A third limitation is that adult-onset congenital myasthenic syndrome was not taken into account and excluded when applying the inclusion/exclusion criteria. 1 Adult-onset congenital myasthenic syndrome particularly affects patients with autosomal dominant congenital myasthenic syndromes. 2 The family history does not necessarily have to be positive in patients with congenital myasthenic syndrome.…”

“…To the Editor: Neuromuscular diseases are prevalent in the general population; patients can often develop disabilities because of these conditions. 1 These disorders can also affect individuals with intellectual and developmental disabilities. 2 The Americans with Disabilities Act stipulates that reasonable accommodations are necessary to ensure individuals with disabilities receive equitable care.…”

Transient Neonatal Myasthenia Gravis as a Common Complication of a Rare Disease: A Systematic Review

“…MuSK-TNMG, like adult MUSK-MG, is often a severe disease with prominent bulbar affection and respiratory insufficiency [51]. TNMG has also been described in the children of mothers with purely ocular MG or double-seronegative MG (i.e., AChR-seronegative and MuSK-seronegative MG) [33,52]. Low-density lipoprotein receptor-related protein 4 (LRP4) antibodies have been seen in some double-seronegative MG patients, but their pathogenicity is not certain.…”