Background Myasthenia gravis (MG) is an autoimmune disease that targets acetylcholine receptor (AChR) of the neuromuscular junction. New-onset MG after SARS-CoV-2 vaccination has rarely been reported. Case presentation We report about three patients who presented new-onset myasthenia gravis after receiving mRNA SARSCoV-2 vaccination. The patients were all males and older than 55 years. All the patients presented with ocular and bulbar symptoms. The interval between vaccine administration and MG onset ranged from 3 days after the frst dose to 10 days after the second dose. All the patients had elevated serum AChR antibodies and responded to pyridostigmine. Two out of three patients were successfully treated with IVIG or plasma exchange and with long-term immunosuppression. Conclusions MG is a rare disease; clinicians should be aware of possible new-onset MG after SARS-CoV-2 vaccination, especially with the current recommendation of booster doses. The hyperstimulation of the innate immune system or the exacerbation of a subclinical pre-existing MG could be possible explanations.

New-onset myasthenia gravis after mRNA SARS-CoV-2 vaccination: a case series

Mauri, Marco
Investigation
;
Cariddi, Lucia Princiotta
Investigation
;
Solazzo, Francesca
Investigation
;
Versino, Maurizio
Ultimo
Writing – Review & Editing
2022-01-01

Abstract

Background Myasthenia gravis (MG) is an autoimmune disease that targets acetylcholine receptor (AChR) of the neuromuscular junction. New-onset MG after SARS-CoV-2 vaccination has rarely been reported. Case presentation We report about three patients who presented new-onset myasthenia gravis after receiving mRNA SARSCoV-2 vaccination. The patients were all males and older than 55 years. All the patients presented with ocular and bulbar symptoms. The interval between vaccine administration and MG onset ranged from 3 days after the frst dose to 10 days after the second dose. All the patients had elevated serum AChR antibodies and responded to pyridostigmine. Two out of three patients were successfully treated with IVIG or plasma exchange and with long-term immunosuppression. Conclusions MG is a rare disease; clinicians should be aware of possible new-onset MG after SARS-CoV-2 vaccination, especially with the current recommendation of booster doses. The hyperstimulation of the innate immune system or the exacerbation of a subclinical pre-existing MG could be possible explanations.
2022
2022
Myasthenia gravis · COVID-19 · SARS-CoV-2 · Vaccine · mRNA
Fanella, Gaia; Baiata, Claudio; Candeloro, Elisa; Toscano, Gianpaolo; Colnaghi, Silvia; Mauri, Marco; Cariddi, Lucia Princiotta; Rebecchi, Valentina; ...espandi
File in questo prodotto:
File Dimensione Formato  
New‑onset myasthenia gravis after mRNA SARS‑CoV‑2 vaccination - 2022.pdf

accesso aperto

Descrizione: Articolo in rivista
Tipologia: Versione Editoriale (PDF)
Licenza: Creative commons
Dimensione 455.25 kB
Formato Adobe PDF
455.25 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11383/2138511
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 11
  • ???jsp.display-item.citation.isi??? 10
social impact