title: Anti-MuSK-positive myasthenia gravis diagnosed during pregnancy: new challenges for an old disease?
abstract: 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.
authors.affiliation: Department of Obstetrics B, Maternidade Bissaya Barreto-Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Ana Raquel
authors.initials: AR
authors.lastname: Neves
authors.affiliation: Department of Obstetrics B, Maternidade Bissaya Barreto-Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Pitorra
authors.initials: P
authors.lastname: Monteiro
authors.affiliation: Department of Neurology, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Anabela
authors.initials: A
authors.lastname: Matos
authors.affiliation: Department of Obstetrics B, Maternidade Bissaya Barreto-Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Santos Silva
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009132:Muscles; D009157:Myasthenia Gravis / Q000150:complications* / Q000276:immunology / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology*; D020794:Receptor Protein-Tyrosine Kinases / Q000276:immunology*; D011950:Receptors, Cholinergic / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D011950:Receptors, Cholinergic; C095714:MUSK protein, human; D020794:Receptor Protein-Tyrosine Kinases