重症肌无力
上睑下垂
医学
吡啶斯替明
免疫学
血清学
提丁
抗体
疾病
病毒学
内科学
外科
肌节
心肌细胞
作者
Karl Jõgi,Liis Sabre,Merit Rosental,Alo-Rainer Leheste,Janek Vilisaar
出处
期刊:COVID
[MDPI AG]
日期:2022-03-30
卷期号:2 (4): 464-471
被引量:4
摘要
During the SARS-CoV-2 (COVID-19) pandemic, the immunogenicity of the virus for various autoimmune complications has been observed. To date, a few reports have been published that raise the possibility of new onset myasthenia gravis (MG) associated with COVID-19 infection. We report a case of a 65-year-old male who developed his initial myasthenic presentation with mild dysarthria 14 days after COVID-19 infection symptomatic onset. His bulbar symptoms, diplopia, and ptosis progressed considerably over the next 1.5 months before he was diagnosed with non-thymomatous MG. Serological tests showed a high concentration of anti-acetylcholine receptor and anti-titin antibodies. He responded well to treatment with pyridostigmine and intravenous immunoglobulin. Reasonable latency from COVID-19 infection and gradual evolvement of myasthenic symptoms makes the causative association probable in this case. To our knowledge, this is the first report of anti-titin antibodies in new-onset MG associated with COVID-19 infection. In the article, we analyze the previously reported cases and summarize the information published to date. We discuss the possible immunological mechanisms behind new onset autoimmune disease following a viral infection and the associated features that raise the suspicion for such a possibility. We also hint at structural homologies between SARS-CoV-2 spike glycoprotein and titin epitopes.
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