Juvenile Autoimmune Myasthenia Gravis due to Thymoma Following Coronavirus Disease 2019 Infection in a Child

Introduction: The acquired myasthenia gravis (MG) is an autoimmune neuromuscular junction (NMJ) disorder. Thymomas and thymic carcinomas are extremely rare in children. We are reporting a rare case of MG following the coronavirus disease 2019 (COVID-19) infection. Case description: A 10-year-old gir...

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Bibliographic Details
Main Authors: Vykuntaraju K Gowda, Varsha Reddy, KVN Dhananjaya, Usha Amirtham
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2023-04-01
Series:Pediatric Infectious Disease
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Online Access:https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1386
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Summary:Introduction: The acquired myasthenia gravis (MG) is an autoimmune neuromuscular junction (NMJ) disorder. Thymomas and thymic carcinomas are extremely rare in children. We are reporting a rare case of MG following the coronavirus disease 2019 (COVID-19) infection. Case description: A 10-year-old girl presented with difficulty in getting up from sitting, swallowing, and drooping of eyelids. Weakness was more in the evening. On examination, bilateral ptosis had a power of 2/5 in the proximal and 3/5 in the distal group of muscle. There was a history of COVID-19 infection 45 days ago. Investigations revealed a decremental response in repetitive nerve stimulation. The neostigmine challenge test noted improvement in ptosis and weakness. Computed tomography (CT) showed a large thymic lesion. Antibody to the acetylcholine receptor (AChR) and COVID-19 spike protein was positive. Treated with oral pyridostigmine, steroids, and thymectomy, and showed significant improvement in power. Histopathology of the excised mediastinal mass revealed type B2 thymoma. Conclusion: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can precipitate MG in the underlying thymoma.
ISSN:2582-4988