Myasthenia Gravis in Pregnancy Treated With Daily Massive Vitamin D Dose

Silva LFF¹, Martins MC¹, Caplum MC¹, Luz MS¹, Amaral VM¹, de Souza VA¹, de Souza HD^2,3,4, Silva ALM6, Panconi CR^2,3,4,5, Zimmermmann JB^{2,3,4,5* 1}Gynecology and Obstetrics Service, Barbacena School of Medicine (FUNJOBE), Barbacena, Minas Gerais State, Brazil ²Medical School of Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais State, Brazil ³Healthcare Center of the University Hospital, Medical School of Federal University of Juiz de Fora, Obstetrics service, Brazil ⁴High-Risk Prenatal Care, Brazil ⁵Zimmermmann Obstetrics and Gynecology Clinic, Brazil ⁶Anesthesiology and Acupuncture Clinic, Brazil

Corresponding Author: Juliana Barroso Zimmermmann ^{ORCID ID} Address: Gynecology and Obstetrics Service, Barbacena School of Medicine (FUNJOBE), Barbacena, Minas Gerais State, Brazil; Email: julianabz@uol.com.br Received date: 27 June 2020; Accepted date: 03 August 2020; Published date: 15 August 2020

Citation: Silva LFF, Martins MC, Caplum MC, Luz MS, Amaral VM, de Souza VA, de Souza HD, Silva ALM, Panconi CR, Zimmermmann JB. Myasthenia Gravis in Pregnancy Treated With Daily Massive Vitamin D Dose. Asp Biomed Clin Case Rep. 2020 Aug 15;3(2):171-77.

Copyright © 2020 Silva LFF, Martins MC, Caplum MC, Luz MS, Amaral VM, de Souza VA, de Souza HD, Silva ALM, Panconi CR, Zimmermmann JB. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.

Keywords: Myasthenia gravis, Autoimmune, Vitamin D, Asthenia, Fatigue

Abstract

Myasthenia gravis (MG) is an autoimmune disease affecting the motor endplate of striated muscle. It is caused by antibodies that act in the cholinergic receptors at the post-synaptic portion of the neuromuscular junction, which results in asthenia and fatigue in some muscle groups. In pregnancy, it’s unpredictable, because pregnant women can present MG exacerbation, remission, stability, or even a myasthenic crisis during pregnancy. Complications are more frequent in the first trimester of pregnancy and the first 30 days of puerperium. Vitamin D and its metabolites are potent immunomodulators since their immuno-regulatory effect directly inhibits effector T cells and induces regulatory T cells (Treg) to decrease the production of inflammatory cytokines. The authors present a case report of a patient with MG who was treated throughout pregnancy with massive doses of vitamin D, obtaining good results.