Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

Steroid pulse therapy was effective against anti-muscle-specific kinase antibody-positive myasthenia gravis crisis: a case report

Satoshi Saito, M.D.1), Syo Wako, M.D.1), Ryusuke Kamada, M.D.1), Shigeo Akiyama, M.D.1) and Shuji Hino, M.D.1)

1) Department of Neurology, Saitama Red Cross Hospital

A 50-year-old woman experienced cardiopulmonary arrest. Although the arrest lasted for 4 min, she could not be withdrawn from the mechanical ventilator because of low tidal volume, despite being awake and alert after admission. The results of the anti-acetylcholine receptor antibody and repetitive nerve stimulation tests were negative, and the anti-muscle-specific kinase antibody levels revealed myasthenia gravis. We recommended therapeutic plasma exchange; however, the patient refused the treatment as she did not want to use blood products. Consequently, we initially attempted steroid pulse therapy, which enabled the patient to be withdrawn from the mechanical ventilator. Thus, steroid pulse therapy was beneficial for the crisis associated with the anti-muscle-specific kinase antibody in the absence of therapeutic plasma exchange.
Full Text of this Article in Japanese PDF (533K)

(CLINICA NEUROL, 63: 379−381, 2023)
key words: anti-MuSK, myasthenia gravis, repetitive nerve stimulation test, respiratory failure, steroid pulse therapy

(Received: 27-Dec-22)