Transient acetylcholine receptor-related myasthenia gravis, post multisystem inflammatory syndrome in children (MIS-C) temporally associated with COVID-19 infection

We report on a unique case of a 7-year-old girl with new onset ocular myasthenia gravis shortly after recovery from multisystem inflammatory syndrome in children (MIS-C) temporally associated with SARS-CoV-2 infection. The diagnosis of myasthenia gravis was based on suggestive symptoms of fatigable...

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Bibliographic Details
Published in:BMJ case reports 2021-08, Vol.14 (8), p.e244102
Main Authors: Essajee, Farida, Lishman, Juanita, Solomons, Regan, Abraham, Deepthi Raju, Goussard, Pierre, Van Toorn, Ronald
Format: Article
Language:English
Subjects:
Aneurysms
Antibodies
Blood pressure
Case Report
Case reports
Child
Children & youth
Coronary vessels
Coronaviruses
COVID-19
Cytokine storm
Ejection fraction
Female
Guillain-Barre syndrome
Humans
Immunoglobulins
Infections
Inflammation
Intensive care
Multisystem inflammatory syndrome in children
Myasthenia gravis
Myasthenia Gravis - complications
Myasthenia Gravis - diagnosis
Myasthenia Gravis - drug therapy
Neuroimaging
Patients
Pediatrics
Proteins
Receptors, Cholinergic
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Steroids
Systemic Inflammatory Response Syndrome
Thymus gland
Viral infections
West Nile virus
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Summary:We report on a unique case of a 7-year-old girl with new onset ocular myasthenia gravis shortly after recovery from multisystem inflammatory syndrome in children (MIS-C) temporally associated with SARS-CoV-2 infection. The diagnosis of myasthenia gravis was based on suggestive symptoms of fatigable bilateral orbital ptosis, diplopia, positive ocular cold compression test and serum acetylcholine receptor antibody positivity, as well as a favourable treatment response to pyridostigmine. The addition of corticosteroids and methotrexate resulted in complete resolution of the ocular signs.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2021-244102