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重症肌无力与妊娠。

Myasthenia gravis and pregnancy.

机构信息

Service d'électroneuromyographie et pathologies neuromusculaires - Hôpital Pierre-Wertheimer - CHU de Lyon HCL - GH Est, 59, boulevard Pinel, Bron cedex, Lyon, France.

Service d'électroneuromyographie et pathologies neuromusculaires - Hôpital Pierre-Wertheimer - CHU de Lyon HCL - GH Est, 59, boulevard Pinel, Bron cedex, Lyon, France.

出版信息

Rev Neurol (Paris). 2021 Mar;177(3):215-219. doi: 10.1016/j.neurol.2020.09.015. Epub 2021 Feb 26.

Abstract

Myasthenia gravis is an autoimmune disease characterised by fluctuating muscle weakness, which worsens during activity. It affects particularly scapular and pelvic girdles, axial and bulbar muscles. Myasthenia gravis is twice more frequent in women and symptoms often appear in the second and third decade of life. Thus, a growing number of women affected by this condition become pregnant. To minimise the effects of myasthenia gravis on pregnancy and the newborn, and to avoid myasthenia crisis in the post-partum, the pregnancy must be planned as far as possible. During pregnancy, treatment must be reviewed due to the threat of teratogenic effects (mycophenolate mofetil, rituximab), and the follow-up must be multidisciplinary.

摘要

重症肌无力是一种自身免疫性疾病,其特征是肌肉无力波动,活动时加重。它特别影响肩胛带和骨盆带、轴性和球部肌肉。女性中重症肌无力的发病率是男性的两倍,症状通常出现在生命的第二和第三个十年。因此,越来越多患有这种疾病的女性怀孕。为了尽量减少重症肌无力对妊娠和新生儿的影响,避免产后重症肌无力危象,妊娠必须尽可能地进行计划。由于有致畸作用的威胁(麦考酚酸酯、利妥昔单抗),因此在怀孕期间必须对治疗进行审查,并且必须进行多学科随访。

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