Neves Ana Raquel, Monteiro Pitorra, Matos Anabela, Santos Silva Isabel
Department of Obstetrics B, Maternidade Bissaya Barreto-Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Department of Neurology, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
BMJ Case Rep. 2015 Jan 5;2015:bcr2014207708. doi: 10.1136/bcr-2014-207708.
Myasthenia gravis is an autoimmune disorder affecting predominantly women in their reproductive age. The course of the disease during pregnancy is unpredictable, although it is more difficult to manage earlier in the gestation. Myasthenia gravis with antibodies against the muscle-specific receptor tyrosine kinase (anti-MuSK) has been described as a subtype of disease with more localised clinical features and a poorer response to treatment than acetylcholine receptor antibody (anti-AChR)-positive patients. Few cases have been reported in pregnant women, with deliveries being performed mainly by caesarean section. We report a successful case of vaginal delivery and describe our experience providing the first review of the management of this subtype of disease during pregnancy.
重症肌无力是一种主要影响育龄女性的自身免疫性疾病。尽管在妊娠早期病情更难控制，但孕期疾病的病程是不可预测的。抗肌肉特异性受体酪氨酸激酶抗体阳性的重症肌无力（抗MuSK MG）已被描述为一种疾病亚型，其临床特征更局限，与乙酰胆碱受体抗体（抗AChR）阳性患者相比，对治疗的反应更差。孕妇中该病例报道较少，分娩主要通过剖宫产进行。我们报告了一例成功的阴道分娩病例，并描述了我们在孕期对该疾病亚型管理进行首次综述的经验。
