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Myasthenia gravis associated with anti‐MuSK antibodies developed after SARS‐CoV‐2 infection.

Authors :
Assini, Andrea
Gandoglia, Ilaria
Damato, Valentina
Rikani, Klaudio
Evoli, Amelia
Del Sette, Massimo
Source :
European Journal of Neurology. Oct2021, Vol. 28 Issue 10, p3537-3539. 3p.
Publication Year :
2021

Abstract

Introduction: Since the onset of the novel coronavirus pandemic, several neurological complications secondary to SARS‐CoV‐2 infection have been reported, affecting central nervous system, peripheral nervous system and neuromuscular junction. Case report: We present the case of a 77‐year‐old man who developed bulbar myasthenia gravis (MG) eight weeks after SARS‐CoV‐2 infection. The search for serum antibodies against the acetylcholine receptor and the muscle‐specific tyrosine kinase (MuSK), performed by radioimmunoassay (RIA), and the search of low‐density lipoprotein receptor‐related protein 4 antibodies, performed by immunohistochemistry, resulted negative, while anti‐MuSK antibodies were detected by cell‐based assay (CBA). The patient was treated with pyridostigmine (60 mg four times a day) with unsatisfactory clinical response, followed by immunosuppressive therapy (azathioprine 1.5 mg/kg/day) with improvement of MG symptoms after two months of treatment. Discussion: Several viral diseases have been described as associated with the onset of MG, although the underlying mechanisms are not yet fully understood. Similarly, a growing number of scientific reports suggest a correlation between SARS‐CoV‐2 infection and autoimmune diseases. The interest of our case lies in the timing of the MG onset (after 2 months from infection), together with the unusual late onset of anti‐MuSK MG. These elements suggest that coronavirus infection may act as a trigger of the disease. We confirm the importance of CBA in the serological diagnosis of RIA‐negative MG. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
13515101
Volume :
28
Issue :
10
Database :
Academic Search Index
Journal :
European Journal of Neurology
Publication Type :
Academic Journal
Accession number :
152468319
Full Text :
https://doi.org/10.1111/ene.14721