Transient Neonatal Myasthenia Gravis Born to a Mother with Asymptomatic MG: A Case Report

Figures & data

Figure 1 (A) Generalized hypotonia with marked poor head erect and suck ability. (B) Need auxiliary ventilation for muscular disorders especially respiratory muscle weakness. (C) Discharged home on day 26 without respiratory and gastric tube support.

Table 1 Muscle-Specific Antibody Receptor for MG Between the Neonate and Mother

Subject	Day after birth	AChR-Ab <0.45nmol/L	MuSK-Ab <0.40U/mL	Titin-Ab	LRP4-Ab	RyR-Ab
Neonate	d5	13.72nmol/L (++)	0.22U/mL (-)	-	-	+
	d25	5.80 nmol/L (+)	0.22U/mL (-)	-	-	+
Mother	d10	3.03nmol/L (-)	0.19U/mL (-)	-	-	-

Notes: “-” negative; “+” weakly positive; “++” strongly positive.

Abbreviations: AChR-Ab, acetylcholine receptor antibody; MuSK-Ab, muscle-specific receptor tyrosine kinase receptor antibody; Titin-Ab, Titin antibody; LRP4-Ab, lipoprotein receptor-related membrane protein 4; RyR-Ab, ryanodine receptor calcium release channel antibody.

Table 2 Details of Drug Use in This Case

Intervention	Day After Birth	Dosage	Administration
IVIG	d7	2.5g/time qd	Intravenous injection 2.2g/kg.total
	d8
	d9
Pyridostigmine	d8	5mg/time q6h 3mg/time q3h 5mg/time q6h 5mg/time q8h	Oral administration Half an hour before milk
	d12
	d20
	d23

Abbreviation: IVIG, intravenous immunoglobulin.

Figure 2 Timeline of clinical symptoms and interventions.