PMID- 30133097
OWN - NLM
STAT- MEDLINE
DCOM- 20190513
LR  - 20190513
IS  - 1468-1331 (Electronic)
IS  - 1351-5101 (Linking)
VI  - 25
IP  - 12
DP  - 2018 Dec
TI  - Maternal myasthenia gravis represents a risk for the child through autoantibody 
      transfer, immunosuppressive therapy and genetic influence.
PG  - 1402-1409
LID - 10.1111/ene.13788 [doi]
AB  - Females with myasthenia gravis (MG) worry about their disease having negative 
      consequences for their children. Autoimmune disease mechanisms, treatment and 
      heredity could all have an impact on the child. This is a subject review where 
      Web of Science was searched for relevant keywords and combinations. Controlled 
      and prospective studies were included, and also results from selected and 
      unselected patient cohorts, guidelines, consensus papers and reviews. Neonatal MG 
      with temporary muscle weakness occurs in 10% of newborn babies where the mother 
      has MG, due to transplacental transfer of antibodies against acetylcholine 
      receptor (AChR), muscle-specific kinase (MuSK) or lipoprotein receptor-related 
      protein 4 (LRP4). Arthrogryposis and fetal AChR inactivation syndrome with 
      contractures and permanent myopathy are rare events caused by mother's antibodies 
      against fetal type AChR. The MG drugs pyridostigmine, prednisolone and 
      azathioprine are regarded as safe during pregnancy and breastfeeding. 
      Methotrexate, mycophenolate mofetil and cyclophosphamide are teratogenic. 
      Mother's MG implies at least a 10-fold increased risk for MG and other autoimmune 
      diseases in the child. MG females should receive specific information about 
      pregnancy and giving birth. First-line MG treatments should usually be continued 
      during pregnancy. Intravenous immunoglobulin and plasma exchange represent safe 
      treatments for exacerbations. Neonatal MG risk means that MG women should give 
      birth at hospitals experienced in neonatal intensive care. Neonatal MG needs 
      supportive care, rarely also acetylcholine esterase inhibition or intravenous 
      immunoglobulin. Women with MG should be supported in their wish to have children.
CI  - (c) 2018 EAN.
FAU - Gilhus, N E
AU  - Gilhus NE
AUID- ORCID: 0000-0001-6522-5102
AD  - Department of Clinical Medicine, University of Bergen, Bergen, Norway.
AD  - Department of Neurology, Haukeland University Hospital, Bergen, Norway.
FAU - Hong, Y
AU  - Hong Y
AD  - Department of Clinical Medicine, University of Bergen, Bergen, Norway.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20180914
PL  - England
TA  - Eur J Neurol
JT  - European journal of neurology
JID - 9506311
RN  - 0 (Autoantibodies)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Receptors, Cholinergic)
RN  - EC 2.7.10.1 (MUSK protein, human)
RN  - EC 2.7.10.1 (Receptor Protein-Tyrosine Kinases)
RN  - KVI301NA53 (Pyridostigmine Bromide)
SB  - IM
MH  - Adult
MH  - *Autoantibodies
MH  - Family
MH  - Female
MH  - Humans
MH  - Immunoglobulins, Intravenous/*adverse effects
MH  - Immunosuppressive Agents/*adverse effects/therapeutic use
MH  - Infant, Newborn
MH  - Myasthenia Gravis/drug therapy/*immunology
MH  - Neuromuscular Diseases
MH  - Pregnancy
MH  - Prenatal Exposure Delayed Effects/*immunology
MH  - Pyridostigmine Bromide/adverse effects/therapeutic use
MH  - Receptor Protein-Tyrosine Kinases/immunology
MH  - Receptors, Cholinergic/immunology
OTO - NOTNLM
OT  - arthrogryposis
OT  - autoantibodies
OT  - breastfeeding
OT  - genetics
OT  - immunosuppressive therapy
OT  - myasthenia gravis
OT  - neonatal myasthenia
OT  - pregnancy
EDAT- 2018/08/23 06:00
MHDA- 2019/05/14 06:00
CRDT- 2018/08/23 06:00
PHST- 2018/05/15 00:00 [received]
PHST- 2018/08/17 00:00 [accepted]
PHST- 2018/08/23 06:00 [pubmed]
PHST- 2019/05/14 06:00 [medline]
PHST- 2018/08/23 06:00 [entrez]
AID - 10.1111/ene.13788 [doi]
PST - ppublish
SO  - Eur J Neurol. 2018 Dec;25(12):1402-1409. doi: 10.1111/ene.13788. Epub 2018 Sep 
      14.