2021•BMJ Case ReportsOpen access

Transient acetylcholine receptor-related myasthenia gravis, post multisystem inflammatory syndrome in children (MIS-C) temporally associated with COVID-19 infection

Farida Essajee, Juanita Lishman, Regan Solomons, Deepthi Raju Abraham, Pierre Goussard, Ronald van Toorn

Abstract

We report on a unique case of a 7-year-old girl with new onset ocular myasthenia gravis shortly after recovery from multisystem inflammatory syndrome in children (MIS-C) temporally associated with SARS-CoV-2 infection. The diagnosis of myasthenia gravis was based on suggestive symptoms of fatigable bilateral orbital ptosis, diplopia, positive ocular cold compression test and serum acetylcholine receptor antibody positivity, as well as a favourable treatment response to pyridostigmine. The addition of corticosteroids and methotrexate resulted in complete resolution of the ocular signs.

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Available abstract

Key concepts: Pyridostigmine, Myasthenia gravis, Ptosis, Medicine, Diplopia, Ocular myasthenia, Acetylcholine receptor, Dermatology