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Myasthenia gravis and infectious disease

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Abstract

Background and purpose

Myasthenia gravis (MG) is an autoimmune disease with muscular weakness as the only symptom, and often with immunosuppressive treatment. All these aspects could have relevance for the risk of infections as well as their prophylactic and curative treatment.

Methods

This is a review article, where Web of Science has been searched for relevant key words and key word combinations. Full papers were selected first by title and then by abstract.

Results and conclusions

MG can be triggered and worsened by infections. No virus or other pathogen has been proven to have a specific link to MG. Treatment with immunosuppressive drugs and thymectomy implies a slightly increased risk for infections. Infections should be actively treated, but a few antibiotics are avoided due to potential interference with neuromuscular transmission. Hospitalization and intensive care may be necessary during infections because of MG deterioration and risk of insufficient respiration. Vaccinations are generally recommended in MG, but live microorganisms should be avoided if possible in immunosuppressed patients.

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Correspondence to Nils Erik Gilhus.

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N.E. Gilhus has received speaker’s honroraria from Octapharma, and honoraria for committee work from Argenx. There are no other conflicts of interest.

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Gilhus, N.E., Romi, F., Hong, Y. et al. Myasthenia gravis and infectious disease. J Neurol 265, 1251–1258 (2018). https://doi.org/10.1007/s00415-018-8751-9

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