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Myasthenia gravis – Genderaspekte und Familienplanung

Myasthenia gravis—Gender aspects and family planning

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Zusammenfassung

Hintergrund

Bei der Myasthenia gravis (MG) gibt es Hinweise, dass geschlechtsspezifische Unterschiede Diagnostik, Therapie und den langfristigen Erkrankungsverlauf beeinflussen können. Bei Frauen erfolgt die Diagnosestellung häufig im gebärfähigen Alter.

Ziel der Arbeit

Geschlechtsspezifische Unterschiede bei MG und relevante Aspekte im klinischen Alltag werden dargestellt. Es werden aktuelle Studien zu Kinderwunsch, Schwangerschaft und Geburt bei MG beleuchtet und Therapieempfehlungen abgeleitet.

Material und Methoden

Narrativer Literaturreview.

Ergebnisse

Geschlechtsspezifische Unterschiede finden sich neben soziodemographischen Daten auch für klinische und paraklinische Faktoren wie Krankheitsschwere und Antikörperstatus. Mit wenigen Ausnahmen ist eine Schwangerschaft mit gutem maternalem und neonatalem Outcome möglich. Während der Schwangerschaft sowie peripartal sollten Kinder von MG-Patientinnen engmaschig monitoriert werden, um potenzielle Erkrankungen, die durch einen diaplazentaren Übertritt maternaler Antikörper hervorgerufen werden, frühzeitig zu erkennen und therapieren.

Schlussfolgerung

Geschlechtsspezifische Faktoren können den Erkrankungsverlauf der MG beeinflussen. Die adäquate ärztliche Beratung und multidisziplinäre Zusammenarbeit ist essenziell für MG-Patientinnen mit Kinderwunsch.

Abstract

Background

There is evidence that gender-specific differences can influence the diagnostics, treatment and long-term disease course of myasthenia gravis (MG). In women the diagnosis is often made during childbearing age.

Objective

Gender-specific differences in MG and relevant aspects in routine clinical practice are presented. In addition, current studies on family planning, pregnancy and childbirth in MG are highlighted and treatment recommendations are derived.

Material and methods

Narrative literature review.

Results

In addition to sociodemographic data, gender-specific differences encompass clinical as well as paraclinical factors, such as disease severity and antibody status. With few exceptions pregnancy is possible with good maternal and neonatal outcome. During pregnancy and peripartum, children of MG patients should be closely monitored for early detection and treatment of potential syndromes caused by diaplacental transfer of maternal antibodies.

Conclusion

Gender-specific factors can influence the course of MG. Adequate medical counselling and multidisciplinary collaboration are essential for MG patients who wish to have children.

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Authors and Affiliations

  1. Department of Neurology, Neuroscience Clinical Research Center (NCRC) and Integrated Myasthenia Gravis Center, Charité – Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland

    Sarah Hoffmann M.Sc. &  Meret Herdick

  2. Department of Obstetrics, Charité – Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland

    Stefan Verlohren

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  1. Sarah Hoffmann M.Sc.
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Correspondence to Sarah Hoffmann M.Sc..

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Interessenkonflikt

S. Hoffmann erhielt Honorare von Alexion, argenx, Roche und UCB für Vorträge und Teilnahme an wissenschaftlichen Beiräten und ist Mitglied des ärztlichen Beirats der Deutschen Myasthenie Gesellschaft (DMG). S. Verlohren erhielt Honorare von Alexion für Vorträge und Teilnahme an wissenschaftlichen Beiräten. M. Herdick erhielt Honorar von argenx für einen Vortrag.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Hoffmann, S., Verlohren, S. & Herdick, M. Myasthenia gravis – Genderaspekte und Familienplanung. Nervenarzt 95, 316–328 (2024). https://doi.org/10.1007/s00115-024-01640-6

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