Transient neonatal myasthenia gravis: a case report
DOI:
https://doi.org/10.24265/horizmed.2025.v25n1.15Keywords:
Myasthenia Gravis, Neonatal, Neostigmine , Muscle HypotoniaAbstract
Transient neonatal myasthenia gravis (TNMG) is an acquired autoimmune disease that occurs in
10 to 20 % of newborns born to mothers with myasthenia gravis. Symptoms appear within the
first 24-72 hours and disappear after weeks or months, with 90 % of patients achieving complete
recovery by 2 months of age. The typical presentation begins with respiratory distress, generalized
hypotonia, and feeding difficulties, requiring clinical surveillance from birth due to the possibility
of early hospitalization.
We present the case of a newborn, born to a mother with myasthenia gravis, who was admitted
at 7 days of age to the Intermediate Care Unit of Hospital Nacional Arzobispo Loayza due to
hypoactivity, poor sucking and hypotonia. Given the suspicion of TNMG due to the maternal
history and the patient’s symptoms, a therapeutic anticholinesterase test was performed,
showing immediate improvement in spontaneous activity and muscle tone, thereby confirming
the diagnosis. The patient received treatment with subcutaneous neostigmine for 6 days, after
which the regimen was changed to oral pyridostigmine to reduce the adverse effects caused by
the previous drug. Finally, the patient was discharged at 26 days of age with favorable evolution
and complete remission. TNMG is rare in newborns; the diagnosis is clinical, with the maternal
history being of utmost importance. Likewise, it requires strict monitoring from birth to recognize
signs and symptoms of the disease, enabling timely initiation of anticholinesterase treatment in
moderate to severe cases, thus preventing long-term sequelae.
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