Description of 3 patients with myasthenia gravis and COVID-19.
Adult
Aged
Azithromycin
/ therapeutic use
Betacoronavirus
COVID-19
Coronavirus Infections
/ complications
Diabetes Mellitus, Type 2
/ complications
Female
Humans
Hydroxychloroquine
/ therapeutic use
Hypertension
/ complications
Hypothyroidism
/ complications
Immunocompromised Host
Immunoglobulins, Intravenous
/ therapeutic use
Immunosuppressive Agents
/ adverse effects
Lopinavir
/ therapeutic use
Male
Myasthenia Gravis
/ complications
Pandemics
Plasmapheresis
Pneumonia, Viral
/ complications
Ritonavir
/ therapeutic use
SARS-CoV-2
Treatment Outcome
COVID-19 Drug Treatment
COVID-19
Myasthenia
Neuroimmunology
Neuromuscular
Journal
Journal of the neurological sciences
ISSN: 1878-5883
Titre abrégé: J Neurol Sci
Pays: Netherlands
ID NLM: 0375403
Informations de publication
Date de publication:
15 10 2020
15 10 2020
Historique:
received:
15
05
2020
revised:
26
06
2020
accepted:
19
07
2020
pubmed:
31
7
2020
medline:
26
9
2020
entrez:
31
7
2020
Statut:
ppublish
Résumé
The COVID-19 pandemic presents two main concerns for patients with myasthenia gravis (MG); chronic immunosuppression may put them at greater risk, and some proposed treatments for COVID-19 could cause MG exacerbation. We present three patients with generalized seropositive MG who developed COVID-19. All patients had a favorable outcome, with only one patient experiencing exacerbation. In this case, exacerbation began before COVID-19; she required ICU admission, non-invasive ventilatory support, and received hydroxychloroquine, lopinavir and ritonavir which were well tolerated. One patient received IVIG in place of scheduled plasma exchange. Outcome was favorable in all cases despite immunosuppressive therapy, use of experimental COVID-19 medication and switching of plasma exchange for IVIG.
Sections du résumé
BACKGROUND
The COVID-19 pandemic presents two main concerns for patients with myasthenia gravis (MG); chronic immunosuppression may put them at greater risk, and some proposed treatments for COVID-19 could cause MG exacerbation.
CASE DESCRIPTION
We present three patients with generalized seropositive MG who developed COVID-19. All patients had a favorable outcome, with only one patient experiencing exacerbation. In this case, exacerbation began before COVID-19; she required ICU admission, non-invasive ventilatory support, and received hydroxychloroquine, lopinavir and ritonavir which were well tolerated. One patient received IVIG in place of scheduled plasma exchange.
CONCLUSION
Outcome was favorable in all cases despite immunosuppressive therapy, use of experimental COVID-19 medication and switching of plasma exchange for IVIG.
Identifiants
pubmed: 32731059
pii: S0022-510X(20)30390-7
doi: 10.1016/j.jns.2020.117053
pmc: PMC7832365
pii:
doi:
Substances chimiques
Immunoglobulins, Intravenous
0
Immunosuppressive Agents
0
Lopinavir
2494G1JF75
Hydroxychloroquine
4QWG6N8QKH
Azithromycin
83905-01-5
Ritonavir
O3J8G9O825
Types de publication
Case Reports
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
117053Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
Références
Neurology. 2020 Jun 2;94(22):959-969
pubmed: 32284362
Ecancermedicalscience. 2020 Mar 27;14:1022
pubmed: 32256705
Clin Infect Dis. 2020 Sep 12;71(6):1393-1399
pubmed: 32271369
J Neurol Sci. 2020 May 15;412:116803
pubmed: 32247193
J Autoimmun. 2020 Jul;111:102468
pubmed: 32317220