Perioperative management of kidney transplantation in patients with myasthenia gravis: a case report with literature review
Abstract Background Myasthenia gravis (MG) is an autoimmune disease with the disorder of the neuromuscular junction, characterized by muscle weakness and easy fatigue. The disease is associated with the development of a myasthenic crisis caused by invasiveness or other factors. MG treatment includes...
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BMC
2025-06-01
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| Series: | Renal Replacement Therapy |
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| Online Access: | https://doi.org/10.1186/s41100-025-00639-2 |
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| author | Ayaka Saitoh Kohei Unagami Takahiro Inoue Yu Kijima Daigo Okada Miyuki Furusawa Kumiko Kitajima Toshihito Hirai Kazuya Omoto Tomokazu Shimizu Masashi Inui Junichi Hoshino Norio Hanafusa Toshio Takagi Hideki Ishida |
| author_facet | Ayaka Saitoh Kohei Unagami Takahiro Inoue Yu Kijima Daigo Okada Miyuki Furusawa Kumiko Kitajima Toshihito Hirai Kazuya Omoto Tomokazu Shimizu Masashi Inui Junichi Hoshino Norio Hanafusa Toshio Takagi Hideki Ishida |
| author_sort | Ayaka Saitoh |
| collection | DOAJ |
| description | Abstract Background Myasthenia gravis (MG) is an autoimmune disease with the disorder of the neuromuscular junction, characterized by muscle weakness and easy fatigue. The disease is associated with the development of a myasthenic crisis caused by invasiveness or other factors. MG treatment includes immunosuppressants and blood purification therapy, similar to the immunosuppressive management in kidney transplantation (KTx). We performed KTx in patients with MG. Case presentation A female patient with chronic renal failure had already been diagnosed with MG, and she had been treated with tacrolimus (TAC) and methylprednisolone (MP). Immunoadsorption therapy was performed twice weekly along with hemodialysis therapy. At 57 years of age, the patient underwent ABO-compatible, donor-specific antibody-positive living donor KTx. TAC, mycophenolate mofetil, MP, basiliximab, and rituximab were administered as immunosuppressants. Plasmapheresis and intravenous immunoglobulins were administered prior to KTx. Conclusions In addition to perioperative invasiveness, a postoperative urinary tract infection had occurred, raising concerns regarding the onset of a crisis. However, the impact of plasmapheresis and other immunosuppressive therapies may have had a positive influence on the perioperative management in this case. |
| format | Article |
| id | doaj-art-5dbdb9ef178541b4b9ca29b5580bc03b |
| institution | OA Journals |
| issn | 2059-1381 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Renal Replacement Therapy |
| spelling | doaj-art-5dbdb9ef178541b4b9ca29b5580bc03b2025-08-20T02:37:36ZengBMCRenal Replacement Therapy2059-13812025-06-011111510.1186/s41100-025-00639-2Perioperative management of kidney transplantation in patients with myasthenia gravis: a case report with literature reviewAyaka Saitoh0Kohei Unagami1Takahiro Inoue2Yu Kijima3Daigo Okada4Miyuki Furusawa5Kumiko Kitajima6Toshihito Hirai7Kazuya Omoto8Tomokazu Shimizu9Masashi Inui10Junichi Hoshino11Norio Hanafusa12Toshio Takagi13Hideki Ishida14Department of Organ Transplant Medicine, Tokyo Women’s Medical UniversityDepartment of Organ Transplant Medicine, Tokyo Women’s Medical UniversityDepartment of Blood Purification, Tokyo Women’s Medical UniversityDepartment of Urology, Tokyo Women’s Medical UniversityDepartment of Urology, Tokyo Women’s Medical UniversityDepartment of Urology, Tokyo Women’s Medical UniversityDepartment of Organ Transplant Medicine, Tokyo Women’s Medical UniversityDepartment of Urology, Tokyo Women’s Medical UniversityDepartment of Urology, Tokyo Women’s Medical UniversityDepartment of Organ Transplant Medicine, Tokyo Women’s Medical UniversityDepartment of Urology, Tokyo Women’s Medical UniversityDepartment of Nephrology, Tokyo Women’s Medical UniversityDepartment of Blood Purification, Tokyo Women’s Medical UniversityDepartment of Urology, Tokyo Women’s Medical UniversityDepartment of Organ Transplant Medicine, Tokyo Women’s Medical UniversityAbstract Background Myasthenia gravis (MG) is an autoimmune disease with the disorder of the neuromuscular junction, characterized by muscle weakness and easy fatigue. The disease is associated with the development of a myasthenic crisis caused by invasiveness or other factors. MG treatment includes immunosuppressants and blood purification therapy, similar to the immunosuppressive management in kidney transplantation (KTx). We performed KTx in patients with MG. Case presentation A female patient with chronic renal failure had already been diagnosed with MG, and she had been treated with tacrolimus (TAC) and methylprednisolone (MP). Immunoadsorption therapy was performed twice weekly along with hemodialysis therapy. At 57 years of age, the patient underwent ABO-compatible, donor-specific antibody-positive living donor KTx. TAC, mycophenolate mofetil, MP, basiliximab, and rituximab were administered as immunosuppressants. Plasmapheresis and intravenous immunoglobulins were administered prior to KTx. Conclusions In addition to perioperative invasiveness, a postoperative urinary tract infection had occurred, raising concerns regarding the onset of a crisis. However, the impact of plasmapheresis and other immunosuppressive therapies may have had a positive influence on the perioperative management in this case.https://doi.org/10.1186/s41100-025-00639-2Myasthenia gravisMyasthenic crisisKidney transplantation |
| spellingShingle | Ayaka Saitoh Kohei Unagami Takahiro Inoue Yu Kijima Daigo Okada Miyuki Furusawa Kumiko Kitajima Toshihito Hirai Kazuya Omoto Tomokazu Shimizu Masashi Inui Junichi Hoshino Norio Hanafusa Toshio Takagi Hideki Ishida Perioperative management of kidney transplantation in patients with myasthenia gravis: a case report with literature review Renal Replacement Therapy Myasthenia gravis Myasthenic crisis Kidney transplantation |
| title | Perioperative management of kidney transplantation in patients with myasthenia gravis: a case report with literature review |
| title_full | Perioperative management of kidney transplantation in patients with myasthenia gravis: a case report with literature review |
| title_fullStr | Perioperative management of kidney transplantation in patients with myasthenia gravis: a case report with literature review |
| title_full_unstemmed | Perioperative management of kidney transplantation in patients with myasthenia gravis: a case report with literature review |
| title_short | Perioperative management of kidney transplantation in patients with myasthenia gravis: a case report with literature review |
| title_sort | perioperative management of kidney transplantation in patients with myasthenia gravis a case report with literature review |
| topic | Myasthenia gravis Myasthenic crisis Kidney transplantation |
| url | https://doi.org/10.1186/s41100-025-00639-2 |
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