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Case Report
Acute exacerbations of myasthenia gravis in COVID-19 infection: A case report on the role of plasmapheresis in preventing intubation
1 Critical Care Division, Anesthesiology and Intensive Therapy Department, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
2 Anesthesiology and Intensive Therapy Department, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
Address correspondence to:
Aino Nindya Auerkari
Cipto Mangunkusumo National General Hospital, Jakarta,
Indonesia
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Article ID: 100134Z06AA2025
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Auerkari AN, Sugiarto A, Aditianingsih D, Marcelia M. Acute exacerbations of myasthenia gravis in COVID-19 infection: A case report on the role of plasmapheresis in preventing intubation. Case Rep Int 2025;14(2):5–11.ABSTRACT
Introduction: Myasthenia gravis (MG) is an autoimmune condition characterized by the production of autoantibodies against acetylcholine receptors, leading to neuromuscular weakness and potentially life-threatening myasthenic crises. The onset of a myasthenic crisis can result from various triggers, including respiratory infections caused by coronavirus disease 2019.
Case Report: We present a case report detailing the management of a 43-year-old Asian woman with acute exacerbation of myasthenia gravis due to coronavirus disease 2019. The patient was at risk of intubation due to respiratory compromise. Plasmapheresis, a method involving the removal and screening of harmful antibodies, was initiated on the fourth hospital day due to worsening respiratory status despite maximal medical management. Five sessions led to marked improvement and prevented the need for intubation.
Conclusion: Early plasmapheresis can be effective in managing MG exacerbations in severe coronavirus disease 2019 and may prevent intubation when initiated in the appropriate clinical context. This intervention demonstrated notable success in addressing respiratory distress, suggesting its viability as a therapeutic approach in similar scenarios.
Keywords: Case report, COVID-19, Myasthenia gravis, Plasmapheresis
SUPPORTING INFORMATION
Author Contributions
Aino Nindya Auerkari - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Adhrie Sugiarto - Acquisition of data, Analysis of data, Drafting the article, Final approval of the version to be published
Dita Aditianingsih - Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Maurin Marcelia - Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Aino Nindya Auerkari et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
