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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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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author Vykuntaraju K Gowda
Varsha Reddy
KVN Dhananjaya
Usha Amirtham
author_facet Vykuntaraju K Gowda
Varsha Reddy
KVN Dhananjaya
Usha Amirtham
author_sort Vykuntaraju K Gowda
collection DOAJ
description 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.
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publishDate 2023-04-01
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series Pediatric Infectious Disease
spelling doaj-art-b6f0698ff2974eb59f1ff0edd3ecf27d2025-08-20T02:56:44ZengJaypee Brothers Medical PublisherPediatric Infectious Disease2582-49882023-04-0151202210.5005/jp-journals-10081-13865Juvenile Autoimmune Myasthenia Gravis due to Thymoma Following Coronavirus Disease 2019 Infection in a ChildVykuntaraju K Gowda0https://orcid.org/0000-0001-7244-0492Varsha Reddy1KVN Dhananjaya2Usha Amirtham3Vykuntaraju K Gowda, Department of Pediatric Neurology, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India, Phone: +91 9535212556Department of Pediatric Neurology, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, IndiaDepartment of Radiodiagnosis & Imaging, Kasturba Medical College, Mangaluru, Karnataka, IndiaDepartment of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, IndiaIntroduction: 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.https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1386acetylcholine receptor antibodiescoronavirus disease 2019 infectiongravismyastheniathymoma
spellingShingle Vykuntaraju K Gowda
Varsha Reddy
KVN Dhananjaya
Usha Amirtham
Juvenile Autoimmune Myasthenia Gravis due to Thymoma Following Coronavirus Disease 2019 Infection in a Child
Pediatric Infectious Disease
acetylcholine receptor antibodies
coronavirus disease 2019 infection
gravis
myasthenia
thymoma
title Juvenile Autoimmune Myasthenia Gravis due to Thymoma Following Coronavirus Disease 2019 Infection in a Child
title_full Juvenile Autoimmune Myasthenia Gravis due to Thymoma Following Coronavirus Disease 2019 Infection in a Child
title_fullStr Juvenile Autoimmune Myasthenia Gravis due to Thymoma Following Coronavirus Disease 2019 Infection in a Child
title_full_unstemmed Juvenile Autoimmune Myasthenia Gravis due to Thymoma Following Coronavirus Disease 2019 Infection in a Child
title_short Juvenile Autoimmune Myasthenia Gravis due to Thymoma Following Coronavirus Disease 2019 Infection in a Child
title_sort juvenile autoimmune myasthenia gravis due to thymoma following coronavirus disease 2019 infection in a child
topic acetylcholine receptor antibodies
coronavirus disease 2019 infection
gravis
myasthenia
thymoma
url https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1386
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