{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:30:04Z","timestamp":1790613004598,"version":"4.1.0"},"reference-count":28,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,1,30]]},"abstract":"<jats:p>Myasthenia gravis is a chronic autoimmune disease of neuromuscular transmission resulting in fatigable skeletal muscle weakness. Preeclampsia is a multisystem disease of pregnancy which is characterised by hypertension and involvement of one or more organ systems. Both diseases are responsible for considerable morbidity and mortality for mother and fetus. The occurrence of both preeclampsia and myasthenia gravis in pregnancy is very rare, and conflicts arise when considering the optimal management of each disease.We present a case of a parturient who was newly diagnosed with both myasthenia gravis and preeclampsia in late pregnancy. Myasthenia treatment was started with prednisolone and pyridostigmine, and delivery was by caesarean section at 37\u2005weeks gestation under spinal anaesthesia. Postnatally, the patient developed worsening of myasthenia and preeclampsia symptoms. We consider the anaesthetic implications for both diseases and describe our approach for the management of this case.<\/jats:p>","DOI":"10.1136\/bcr-2014-208323","type":"journal-article","created":{"date-parts":[[2015,2,26]],"date-time":"2015-02-26T07:17:41Z","timestamp":1424935061000},"page":"bcr2014208323","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["New diagnosis myasthenia gravis and preeclampsia in late pregnancy"],"prefix":"10.1136","volume":"2015","author":[{"given":"John","family":"Ozcan","sequence":"first","affiliation":[{"name":"Department of Anaesthetics, The Royal Women's Hospital, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian Frank","family":"Balson","sequence":"additional","affiliation":[{"name":"Department of Anaesthetics, The Royal Women's Hospital, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia T","family":"Dennis","sequence":"additional","affiliation":[{"name":"Department of Anaesthetics, The Royal Women's Hospital, Parkville, Victoria, Australia"},{"name":"The Department of Obstetrics and Gynaecology and The Department of Pharmacology, The University of Melbourne, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,2,26]]},"reference":[{"key":"2025082803374223000_2015.feb26_1.bcr2014208323.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cacc.2007.01.006"},{"key":"2025082803374223000_2015.feb26_1.bcr2014208323.2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/123.4.665"},{"key":"2025082803374223000_2015.feb26_1.bcr2014208323.3","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-199103000-00012"},{"key":"2025082803374223000_2015.feb26_1.bcr2014208323.4","first-page":"321","article-title":"Immunological diseases in pregnancy","volume":"23","author":"Scott","year":"1977","journal-title":"Prog Allergy"},{"key":"2025082803374223000_2015.feb26_1.bcr2014208323.5","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.preghy.2014.02.001","article-title":"The classification, diagnosis and management of the hypertensive disorders of pregnancy: a revised statement from the International Society for the Study of Hypertension in Pregnancy (ISSHP)","volume":"4","author":"Tranquilli","year":"2014","journal-title":"Pregnancy Hypertens"},{"key":"2025082803374223000_2015.feb26_1.bcr2014208323.6","first-page":"35S","article-title":"Myasthenia gravis and preeclampsia","volume":"48","author":"Cohen","year":"1976","journal-title":"Obstet Gynecol"},{"key":"2025082803374223000_2015.feb26_1.bcr2014208323.7","first-page":"355","article-title":"Preeclampsia and the patient with myasthenia gravis","volume":"54","author":"Duff","year":"1979","journal-title":"Obstet Gynecol"},{"key":"2025082803374223000_2015.feb26_1.bcr2014208323.8","first-page":"84","article-title":"Myasthenia gravis and pre-eclampsia","volume":"76","author":"Brogan","year":"1983","journal-title":"Ir Med J"},{"key":"2025082803374223000_2015.feb26_1.bcr2014208323.9","first-page":"229","article-title":"Myasthenia gravis and preeclampsia","volume":"30","author":"Benshushan","year":"1994","journal-title":"Isr J Med Sci"},{"key":"2025082803374223000_2015.feb26_1.bcr2014208323.10","first-page":"587","article-title":"Association of preeclampsia and myasthenia: a case report","volume":"54","author":"Hamaoui","year":"2009","journal-title":"J Reprod Med"},{"key":"2025082803374223000_2015.feb26_1.bcr2014208323.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2003.12.027"},{"key":"2025082803374223000_2015.feb26_1.bcr2014208323.12","unstructured":"National Collaborating Centre for Women's and Children's Health. 2011 Hypertension in pregnancy. 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