Myasthenia gravis and preeclampsia: Dot all the I's and cross all the T's
Although rare, the co-occurrence of myasthenia gravis and preeclampsia during pregnancy is responsible for considerable maternal and foetal morbidity and mortality. Both careful selection of medications and a multidisciplinary approach are required for treating such cases. This study presents a case...
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| Format: | Article |
| Language: | English |
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Elsevier
2017-10-01
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| Series: | Journal of Taibah University Medical Sciences |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1658361217300513 |
| _version_ | 1811255491968368640 |
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| author | Ali Hassan, FCPS |
| author_facet | Ali Hassan, FCPS |
| author_sort | Ali Hassan, FCPS |
| collection | DOAJ |
| description | Although rare, the co-occurrence of myasthenia gravis and preeclampsia during pregnancy is responsible for considerable maternal and foetal morbidity and mortality. Both careful selection of medications and a multidisciplinary approach are required for treating such cases. This study presents a case report of a patient with a known history of generalized myasthenia gravis who presented with preeclampsia at 33 weeks' gestation. Subsequently, the patient developed recurrent seizures that necessitated the use of multiple medications, including phenytoin, valproic acid, levetiracetam, and propofol. Magnesium sulphate was not administered due to its blocking effect on calcium channels at the neuromuscular junction. The patient underwent a caesarean section under spinal anaesthesia and gave birth to a baby with intrauterine growth restriction (IUGR). Blood pressure control was achieved with the administration of methyldopa and parenteral hydralazine, an increased dose of pyridostigmine, and intravenous immunoglobulin therapy. The status of the patient's myasthenia gravis remained stable. This case serves to highlight the conflicts in the management of these two disorders and suggests strategies to resolve these conflicts in clinical management. |
| first_indexed | 2024-04-12T17:24:40Z |
| format | Article |
| id | doaj.art-959e9a4c124c463e85ae786f96ec1945 |
| institution | Directory Open Access Journal |
| issn | 1658-3612 |
| language | English |
| last_indexed | 2024-04-12T17:24:40Z |
| publishDate | 2017-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Taibah University Medical Sciences |
| spelling | doaj.art-959e9a4c124c463e85ae786f96ec19452022-12-22T03:23:21ZengElsevierJournal of Taibah University Medical Sciences1658-36122017-10-0112546146410.1016/j.jtumed.2017.01.006Myasthenia gravis and preeclampsia: Dot all the I's and cross all the T'sAli Hassan, FCPSAlthough rare, the co-occurrence of myasthenia gravis and preeclampsia during pregnancy is responsible for considerable maternal and foetal morbidity and mortality. Both careful selection of medications and a multidisciplinary approach are required for treating such cases. This study presents a case report of a patient with a known history of generalized myasthenia gravis who presented with preeclampsia at 33 weeks' gestation. Subsequently, the patient developed recurrent seizures that necessitated the use of multiple medications, including phenytoin, valproic acid, levetiracetam, and propofol. Magnesium sulphate was not administered due to its blocking effect on calcium channels at the neuromuscular junction. The patient underwent a caesarean section under spinal anaesthesia and gave birth to a baby with intrauterine growth restriction (IUGR). Blood pressure control was achieved with the administration of methyldopa and parenteral hydralazine, an increased dose of pyridostigmine, and intravenous immunoglobulin therapy. The status of the patient's myasthenia gravis remained stable. This case serves to highlight the conflicts in the management of these two disorders and suggests strategies to resolve these conflicts in clinical management.http://www.sciencedirect.com/science/article/pii/S1658361217300513EclampsiaMyasthenia gravisPreeclampsiaPregnancyRecurrent seizures |
| spellingShingle | Ali Hassan, FCPS Myasthenia gravis and preeclampsia: Dot all the I's and cross all the T's Journal of Taibah University Medical Sciences Eclampsia Myasthenia gravis Preeclampsia Pregnancy Recurrent seizures |
| title | Myasthenia gravis and preeclampsia: Dot all the I's and cross all the T's |
| title_full | Myasthenia gravis and preeclampsia: Dot all the I's and cross all the T's |
| title_fullStr | Myasthenia gravis and preeclampsia: Dot all the I's and cross all the T's |
| title_full_unstemmed | Myasthenia gravis and preeclampsia: Dot all the I's and cross all the T's |
| title_short | Myasthenia gravis and preeclampsia: Dot all the I's and cross all the T's |
| title_sort | myasthenia gravis and preeclampsia dot all the i s and cross all the t s |
| topic | Eclampsia Myasthenia gravis Preeclampsia Pregnancy Recurrent seizures |
| url | http://www.sciencedirect.com/science/article/pii/S1658361217300513 |
| work_keys_str_mv | AT alihassanfcps myastheniagravisandpreeclampsiadotalltheisandcrossallthets |