Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction. Preeclampsia/HELLP Syndrome is a potentially life-threatening pregnancy complication. The combination of HELLP Syndrome and MG is challenging because the preferred treatment regimens for both conditions generally contradict each other. Our aim is to describe the management options when these two diseases occur simultaneously. We present a case in which a woman with an established diagnosis of MG developed HELLP Syndrome at 31 weeks gestation. Magnesium sulfate prophylaxis was not utilized because of the patient’s MG diagnosis. A cesarean delivery was performed. Reported cases with combined diagnoses of MG and preeclampsia/HELLP Syndrome are reviewed and adjustments to treatment plans are discussed. Management of such patients should be done with a multidisciplinary approach in advanced medical centers with careful consideration of the medications used.
Myasthenia gravis, magnesium sulfate, HELLP Syndrome, preeclampsia, pyridostigmine
The authors report no conflict of interest.
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Department of Obstetrics and Gynecology, The University of Iowa Hospitals and Clinics
Bahat PY, Turan G, Koroglu N, Cetin BA, Topcu EG. Combination of myasthenia gravis and HELLP Syndrome in pregnancy: case report and literature review. POG in Press. 2018 May; Article 1 [10 p.]. Available from: http://ir.uiowa.edu/pog_in_press/. Free full text article.