Successfully Treated Hepatitis B Positive Refractory Myasthenic Crisis with Rituximab

Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine
R Kumar SinghShivani Rath

Abstract

Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular transmission, which presents with fluctuating and variable weakness in ocular, bulbar, limb, and respiratory muscles resulting from an antibody-mediated, T-cell-dependent immunologic attack on the postsynaptic membrane of the neuromuscular junction. Although treatment of MG and myasthenic crisis is based on few specific principles, it is highly individualized. We report a successfully treated case of refractory myasthenic crisis who was on a ventilator for 7 months (210 days), perhaps the longest from India, and required multiple cycles of plasma exchange, intravenous immunoglobulin infusion, and one cycle of rituximab. It exemplifies the role of highly individualized therapy and interdisciplinary cooperation in management of refractory myasthenic crisis. Singh RK, Joshi D, Rath S. Successfully Treated Hepatitis B Positive Refractory Myasthenic Crisis with Rituximab. Indian J Crit Care Med 2020;24(1):71-72.

References

Mar 31, 2000·Nature Medicine·R A ClynesJ V Ravetch
Aug 21, 2013·Annals of Indian Academy of Neurology·Sudhir SharmaRitesh Agarwal
Jul 1, 2016·Neurology·Donald B SandersPushpa Narayanaswami
Dec 1, 2017·Annals of Indian Academy of Neurology·L Yadav RahulArabinda Mukherjee

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