Juvenile and Neonatal Myasthenia Gravis

Peter B. Kang, Wendy K.M. Liew, Maryam Oskoui, Angela Vincent

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Scopus citations

Abstract

Juvenile myasthenia gravis is rare compared to adult myasthenia gravis, but in some respects is a distinct subtype of this autoimmune neuromuscular disease. Prepubertal children are more likely to present with pure ocular symptoms and display a balanced gender ratio, whereas adolescents are more likely to develop generalized myasthenia gravis and to be female. The treatment options are similar in juvenile and adult myasthenia gravis; however, the risk-benefit calculations differ due to the particular vulnerabilities of the pediatric population. Steroids, which play an important role in the treatment of juvenile myasthenia gravis, may cause more lasting harm in children and adolescents compared to adults. Venous access for plasmapheresis is often more challenging in the pediatric setting, yet this therapeutic option should be considered whenever technically feasible. Neonatal myasthenia gravis is caused by transplacental transmission of acetylcholine receptor antibodies. Most affected infants require only respiratory and nutritional support and have excellent outcomes. By contrast, fetal-specific transfer of acetylcholine receptor antibodies can lead to arthrogryposis or other fetal acetylcholine receptor inactivation syndromes, associated with more significant long-term complications.

Original languageEnglish (US)
Title of host publicationNeuromuscular Disorders of Infancy, Childhood, and Adolescence
Subtitle of host publicationA Clinician's Approach
PublisherElsevier Inc.
Pages482-496
Number of pages15
ISBN (Electronic)9780124171275
ISBN (Print)9780124170445
DOIs
StatePublished - 2015
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2014 Elsevier Inc. All rights reserved.

Keywords

  • Acetylcholine receptor
  • Fetal acetylcholine receptor inactivation syndrome
  • Juvenile myasthenia gravis
  • Neonatal myasthenia gravis
  • Thymectomy

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