Anti-musk Myasthenic Crisis in the Puerperium: The Management Dilemma
Peter Appiah–Thompson, Yaw Asante Awuku, Paul Masiowski, Benedicta L. Appiah–Thompson, Olukemi Olawaiye Dampson
Journal of Advances in Medicine and Medical Research · pp. 1–5 · Published 24 Aug 2015
10.9734/BJMMR/2015/20381Abstract
Myasthenia gravis (MG) is a chronic neuromuscular junction (NMJ) dysfunction with a wide spectrum of neurological manifestations. MG is as a result of autoantibodies directed against NMJ at the postsynaptic level involving nicotinic or other postsynaptic antigens. The newly identified subtype of MG with antibodies against the muscle-specific receptor tyrosine kinase (Anti-MuSK) shows an unpredictable response to current MG treatment. The initial presentation of this disease entity often poses a diagnostic challenge and a treatment dilemma to the clinician. We present a case of life threatening Anti-MuSK-positive myasthenic crisis occurring during puerperium which required a temporary surgical airway and percutaneous endoscopic gastrostomy tube for feeding. She had dysphonia for 7 years but was not diagnosed. The complications and management dilemma of this case report are highlighted.
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