Complement inhibition initiated recovery of a severe myasthenic crisis with COVID-19

J Neurol. 2021 Sep;268(9):3125-3128. doi: 10.1007/s00415-021-10428-6. Epub 2021 Feb 4.

Abstract

We report on a patient with refractory Myasthenia gravis with acetylcholine receptor antibodies with two prior myasthenic crises suffering from COVID-19 with rapid evolving weakness and respiratory failure. Respiratory failure developed and prolonged mechanical ventilation was necessary. After plasmapheresis, residual, severe generalized and bulbar weakness persisted. Complement inhibition with eculizumab was, therefore, introduced and lead to rapid recovery. In refractory myasthenic crisis individualised therapies could be successful.

Keywords: COVID-19; Complement inhibition; Immunosuppression; Myasthenia gravis.

MeSH terms

  • COVID-19*
  • Humans
  • Myasthenia Gravis* / complications
  • Myasthenia Gravis* / drug therapy
  • Receptors, Cholinergic
  • Respiratory Insufficiency*
  • SARS-CoV-2

Substances

  • Receptors, Cholinergic