PDF(Pubmed)
Abstract：
Myasthenia gravis (MG) is an autoimmune disease which can impact pregnancy. We describe a transient neonatal myasthenia gravis (TNMG) born to an asymptomatic mother aged 26. The newborn presented cyanosis and generalized muscular weakness quickly after birth. Nasal continuous positive airway pressure (nCPAP) ventilation was performed immediately. On day 3, detailed family history showed that the neonate\'s 50-year-old maternal grandmother was diagnosed as ocular MG at the age of 40. Ryanodine receptor calcium release channel antibody (RyR-Ab) and acetylcholine receptor antibody (AChR-Ab) tested on day 5 were positive. However, neostigmine tests were negative for the neonate. Intravenous immunoglobulin (IVIG) and oral pyridostigmine were administered. The infant was weaned from the ventilator on day 7. On day 10, the neonate\'s asymptomatic mother was confirmed to have positive AChR-Ab either. The neonate regained the capability of bottle feeding on day 17 and discharged on day 26. Asymptomatic pregnant women with MG family history can also deliver infants who develop TNMG. Testing AChR antibodies in pregnant women with a family history of MG should be necessary as TNMG was a life-threatening disease. With timely diagnosis and accurate treatment, TNMG can be effectively relieved.
摘要：
重症肌无力（MG）是一种自身免疫性疾病，可影响妊娠。我们描述了26岁无症状母亲所生的短暂性新生儿重症肌无力（TNMG）。新生儿出生后迅速出现紫癜和全身性肌无力。立即进行经鼻持续气道正压通气（nCPAP）。第3天，详细的家族史显示，该新生儿50岁的外婆在40岁时被诊断为眼部MG。在第5天测试的Ryanodine受体钙释放通道抗体(RyR-Ab)和乙酰胆碱受体抗体(AChR-Ab)为阳性。然而,新生儿的新斯的明试验呈阴性。给予静脉免疫球蛋白（IVIG）和口服吡啶斯的明。婴儿在第7天从呼吸机断奶。在第10天，新生儿的无症状母亲被证实具有阳性的AChR-Ab。新生儿在第17天恢复了奶瓶喂养的能力，并在第26天出院。有MG家族史的无症状孕妇也可以分娩发展为TNMG的婴儿。在有MG家族史的孕妇中测试AChR抗体应该是必要的，因为TNMG是一种危及生命的疾病。及时诊断和准确治疗，可有效缓解TNMG。
