Pediatric Infectious Disease

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VOLUME 5 , ISSUE 1 ( January-March, 2023 ) > List of Articles


Juvenile Autoimmune Myasthenia Gravis due to Thymoma Following Coronavirus Disease 2019 Infection in a Child

Vykuntaraju K Gowda, Varsha Reddy, KVN Dhananjaya, Usha Amirtham

Keywords : Acetylcholine receptor antibodies, Coronavirus disease 2019 infection, Gravis, Myasthenia, Thymoma

Citation Information : Gowda VK, Reddy V, Dhananjaya K, Amirtham U. Juvenile Autoimmune Myasthenia Gravis due to Thymoma Following Coronavirus Disease 2019 Infection in a Child. Pediatr Inf Dis 2023; 5 (1):20-22.

DOI: 10.5005/jp-journals-10081-1386

License: CC BY-NC 4.0

Published Online: 15-04-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Introduction: The acquired myasthenia gravis (MG) is an autoimmune neuromuscular junction (NMJ) disorder. Thymomas and thymic carcinomas are extremely rare in children. We are reporting a rare case of MG following the coronavirus disease 2019 (COVID-19) infection. Case description: A 10-year-old girl presented with difficulty in getting up from sitting, swallowing, and drooping of eyelids. Weakness was more in the evening. On examination, bilateral ptosis had a power of 2/5 in the proximal and 3/5 in the distal group of muscle. There was a history of COVID-19 infection 45 days ago. Investigations revealed a decremental response in repetitive nerve stimulation. The neostigmine challenge test noted improvement in ptosis and weakness. Computed tomography (CT) showed a large thymic lesion. Antibody to the acetylcholine receptor (AChR) and COVID-19 spike protein was positive. Treated with oral pyridostigmine, steroids, and thymectomy, and showed significant improvement in power. Histopathology of the excised mediastinal mass revealed type B2 thymoma. Conclusion: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can precipitate MG in the underlying thymoma.

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