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Transient neonatal myasthenia gravis pada bayi baru lahir dari ibu dengan myasthenia gravis: laporan kasus langka

  • Shana Yusie Anwar ,
  • Emmy Hayatun ,
  • Siti Hairiah ,

Abstract

Introduction: Transient Neonatal Myasthenia Gravis (TNMG) is a temporary neuromuscular disorder that occurs in babies born to mothers with myasthenia gravis (MG) due to transplacental transfer of antibodies against acetylcholine receptors. TNMG is a rare form that occurs in 10-15% of babies born to mothers with MG.

Case: We present the case of a newborn who was admitted to the Neonatal Intensive Care Unit after birth by caesarean section (SC) for observation of MG symptoms due to birth to an asymptomatic MG mother. The baby showed symptoms two days after birth with general hypotonia, weak facial motor skills, always open mouth, missing primitive reflexes, whimpering cries, difficulty swallowing and sucking, and the baby's position was like a frog's leg. On supporting examination, no electrolyte disturbances were found, kidney function was normal. Observation was continued to eliminate differential diagnoses. The baby may experience TNMG on the fifth day of treatment based on the diagnosis of exclusion and the mother's history of MG. A positive maternal history of MG associated with a suggestive physical examination is sufficient to make a diagnosis of TNMG.

Conclusion: With prompt diagnosis and appropriate management, most newborns experience spontaneous remission after several weeks to months.

 

Pendahuluan: Transient Neonatal Myasthenia Gravis (TNMG) adalah gangguan neuromuskuler sementara yang terjadi pada bayi yang lahir dari ibu dengan myasthenia gravis (MG) karena transfer transplacental antibodi terhadap asetilkolin reseptor. TNMG adalah bentuk langka yang terjadi pada 10-15% bayi yang lahir dari ibu dengan MG.

Kasus: Penulis menyajikan kasus bayi baru lahir yang dirawat di Unit Perawatan Intensif Neonatal setelah lahir sectio caesarea (SC) untuk observasi adanya gejala MG akibat lahir dari ibu MG asimptomatik. Bayi menunjukkan gejala dua hari setelah dilahirkan dengan hipotonia umum, motorik wajah melemah, mulut selalu terbuka, refleks primitif yang hilang, tangisan merintih, kesulitan menelan dan menghisap, serta posisi bayi seperti kaki katak. Pada pemeriksaan penunjang tidak ditemukan gangguan elektrolit, fungsi ginjal normal. Observasi dilanjutkan untuk menyingkirkan diferensial diagnosis. Bayi dicurigai mengalami TNMG dihari kelima perawatan berdasarkan diagnosis ekslusi dan riwayat ibu dengan MG. Riwayat MG yang positif pada ibu terkait dengan pemeriksaan fisik sugestif cukup untuk membuat diagnosis TNMG.

Simpulan: Dengan diagnosis yang cepat dan penatalaksanaan yang tepat, sebagian besar bayi baru lahir mengalami remisi spontan setelah beberapa minggu sampai bulan.

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How to Cite

Shana Yusie Anwar, Emmy Hayatun, & Siti Hairiah. (2024). Transient neonatal myasthenia gravis pada bayi baru lahir dari ibu dengan myasthenia gravis: laporan kasus langka. Intisari Sains Medis, 15(1), 174–177. https://doi.org/10.15562/ism.v15i1.1964

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