Myasthenia Gravis in Pregnancy Treated With Daily Massive Vitamin D Dose

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.