Dharmasaroja Permphan
Neurology, Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, THA.
Cureus. 2022 Jan 24;14(1):e21571. doi: 10.7759/cureus.21571. eCollection 2022 Jan.
Myasthenia gravis (MG) is an autoimmune disorder characterized by abnormal neuromuscular transmission. The thymus is believed to play a key role in the pathogenesis of MG, and thymectomy has been an optional treatment for the disease. Relapse of MG after thymectomy has been reported. Exacerbations and new onset of MG following COVID-19 vaccination have also been documented. This report presents a case of a stable MG patient with recent COVID-19 vaccination experiencing flare-ups of symptoms shortly after video-assisted thoracoscopic (VATS) thymectomy. A 31-year-old female received the second dose of the BNT162b2 mRNA COVID-19 vaccine eight days before thymectomy and developed flare-ups of symptoms four days after the surgery. Although the substantial link between MG exacerbations post-thymectomy and pre-thymectomy COVID-19 vaccination cannot be concluded, this observation warrants further research.
重症肌无力(MG)是一种以神经肌肉传递异常为特征的自身免疫性疾病。胸腺被认为在MG的发病机制中起关键作用,胸腺切除术一直是该疾病的一种可选治疗方法。已有胸腺切除术后MG复发的报道。接种新冠病毒疫苗后MG病情加重及新发病例也有记录。本报告介绍了一例病情稳定的MG患者,近期接种新冠病毒疫苗后,在电视辅助胸腔镜(VATS)胸腺切除术后不久症状出现发作。一名31岁女性在胸腺切除术前8天接种了第二剂BNT162b2 mRNA新冠病毒疫苗,并在手术后4天出现症状发作。虽然不能得出胸腺切除术后MG病情加重与胸腺切除术前接种新冠病毒疫苗之间存在实质性关联的结论,但这一观察结果值得进一步研究。