Jenny Lindroos, MD, University of Bergen, Bergen, Norway, outlines future aims in management of myasthenia gravis (MG) with regards to pregnancy and neonates. While the acetylcholine receptor (AChR) autoantibodies responsible for MG always pass to children of mothers with MG in the womb, not all children have transient neonatal MG (TNMG). It is unknown why only some neonates develop the condition, or why some have delayed onset – a key aim is to be able to predict this. TNMG is associated with permanent skeletal malformations like arthrogryposis multiplex congenita, as well as some less severe malformations. Dr Lindroos highlights that skeletal deformations could be detected in pregnancy ultrasounds, so pregnant women with MG should have extra ultrasounds to detect this, as well as other symptoms that may predict TNMG like reduced fetal movement. There are currently no clear treatment approach for TNMG; immunosuppressant medications and intravenous immunoglobulin are believed to reduce the risk, but more systematic studies are needed. Dr Lindroos also suggests that thymectomy should be performed before pregnancy. This interview took place at the European Academy of Neurology (EAN) Annual Meeting 2024 in Helsinki, Finland.
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