Eficácia da Troca Plasmática na Miastenia Gravis Após Longa COVID em um Contexto com Recursos Limitados: Relato de Caso

Barra lateral de artigos

PDF (English) PDF
Publicado: Jun 9, 2025
DOI: https://doi.org/10.52600/2763-583X.bjcr.2025.5.1.bjcr91
Palavras-chave:
COVID longa, Miastenia Gravis, Troca Plasmática, Hemoclear

Conteúdo do artigo principal

Rosita Bihariesingh-Sanchit
Department of Anaesthesiology, Academic Hospital Paramaribo
https://orcid.org/0000-0003-0646-9507
Rakesh Bansie
Department of Internal Medicine Academic Hospital Paramaribo
https://orcid.org/0000-0002-5885-3677
Rocade Ma
Department of Anaesthesiology, Academic Hospital Paramaribo
Sharon Veenbergen
Department of Immunology, University Medical Center Rotterdam
Dimitri Adriaan Diavatopoulos
Department of Laboratory Medicine, Laboratory of Medical Immunology, Radboud University Medical Center
Marien Isaäk de Jonge
Department of Laboratory Medicine, Laboratory of Medical Immunology
Arno Nierich
HemoClear BV

Resumo

Este relato de caso descreve o desenvolvimento de miastenia gravis (MG) em um paciente do sexo masculino de 71 anos com COVID longa e detalha o manejo de uma exacerbação da MG. O paciente apresentou sintomas significativos, incluindo fadiga, comprometimento cognitivo, disfagia e disartria. Embora tenha sido observada melhora transitória após o tratamento com piridostigmina, a condição do paciente posteriormente se agravou, com fraqueza axial e bucofaríngea acentuada. O alívio dos sintomas foi finalmente alcançado por meio de plasmaférese utilizando um método de fluxo cruzado por gravidade de baixo volume. Este caso destaca o potencial impacto a longo prazo da COVID-19 em doenças autoimunes como a MG e reforça a necessidade de vigilância no manejo de complicações neurológicas pós-COVID.

Detalhes do artigo

Como Citar
Bihariesingh-Sanchit, R., Bansie, R., Ma, R., Veenbergen, S., Diavatopoulos, D. A., Jonge, M. I. de, & Nierich, A. (2025). Eficácia da Troca Plasmática na Miastenia Gravis Após Longa COVID em um Contexto com Recursos Limitados: Relato de Caso. Brazilian Journal of Case Reports, 5(1), bjcr91. https://doi.org/10.52600/2763-583X.bjcr.2025.5.1.bjcr91
Edição
v. 5 n. 1 (2025): January/December - 2025
Seção
Clinical Case Reports
Creative Commons License
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Biografia do Autor

Rosita Bihariesingh-Sanchit, Department of Anaesthesiology, Academic Hospital Paramaribo

Department of Anaesthesiology, Academic Hospital Paramaribo, Republic of Suriname.

Rakesh Bansie, Department of Internal Medicine Academic Hospital Paramaribo

Department of Internal Medicine Academic Hospital Paramaribo, Republic of Suriname.

Rocade Ma, Department of Anaesthesiology, Academic Hospital Paramaribo

Department of Anaesthesiology, Academic Hospital Paramaribo, Republic of Suriname.

Sharon Veenbergen, Department of Immunology, University Medical Center Rotterdam

Department of Immunology, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Dimitri Adriaan Diavatopoulos, Department of Laboratory Medicine, Laboratory of Medical Immunology, Radboud University Medical Center

Department of Laboratory Medicine, Laboratory of Medical Immunology, Radboud   University Medical Center, Nijmegen, The Netherlands.

Radboud Community for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, The Netherlands.

Marien Isaäk de Jonge, Department of Laboratory Medicine, Laboratory of Medical Immunology

Department of Laboratory Medicine, Laboratory of Medical Immunology, Radboud  University Medical Center, Nijmegen, The Netherlands.

Radboud Community for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, The Netherlands.

Arno Nierich, HemoClear BV

HemoClear BV, Zwolle, The Netherlands.

Referências

Nalbandian A, Sehgal K, Gupta A, Madhavan MV, McGroder C, Stevens JS, et al. Post-acute COVID-19 syndrome. Nat Med. 2021 Apr;27(4):601-615. doi: 10.1038/s41591-021-01283-z.

Gilhus NE, Tzartos S. Bulbar symptoms and long-term prognosis in myasthenia gravis. Nat Rev Neurol. 2019 May;15(5):287-299. doi: 10.1038/s41582-019-0195-2.

Sanders DB, Wolfe GI, Benatar M, Evoli A, Gilhus NE, Illa I, et al. International consensus guidance for management of myasthenia gravis: Executive summary. Neurology. 2016 Jul 26;87(4):419-425. doi: 10.1212/WNL.0000000000002790.

Tugasworo D, Kurnianto A, Retnaningsih D, et al. The relationship between myasthenia gravis and COVID-19: A systematic review. Egypt J Neurol Psychiatr Neurosurg. 2022;58:83. doi: 10.1186/s41983-022-00516-3.

Bihariesingh-Sanchit R, Bansie R, Sam STA, Lieveld C, Simons A, Kromosoeto J, et al. Gravity-driven crossflow membrane filtration and mechanical centrifugation yield plasma with equivalent total and COVID-19-specific immunoglobulin content. World J Adv Res Rev. 2024;21(2):1107-1115. doi: 10.30574/wjarr.2024.21.2.0527.

Khatri BO, Raval JS. When and how to use plasma exchange therapy for difficult-to-treat multiple sclerosis patients. Inte-chOpen [Internet]. 2025 May 7 [cited 2025 Jun 7]; Available from: https://www.intechopen.com/online-first/1216614. doi: 10.5772/intechopen.1010410.

Restivo DA, Mazzone ME, Marchese-Ragona R, Centonze D, Alesina A. Myasthenia gravis associated with SARS-CoV-2 infection: A case report and review of the literature. J Neurol. 2022 Jan;269(1):45-48. doi: 10.1007/s00415-021-10785-2.

Sriwastava S, Shrestha AK, Khalid SH, Tandon M, Kataria S, Daimee M, et al. New-onset myasthenia gravis after SARS-CoV-2 infection: Case report and literature review. BMJ Case Rep. 2021 Sep;14(9):e244146. doi: 10.1136/bcr-2021-244146.

Dalakas MC. Autoimmune neurological syndromes triggered by COVID-19: A systematic review. Nat Rev Neurol. 2021 Mar;17(3):143-154. doi: 10.1038/s41582-020-00444-9.

Jacob S, Kapadia R, Soule T, Luo H, Schellenberg KL, Douville RN, et al. Neuromuscular complications of SARS-CoV-2 and other viral infections. Front Neurol. 2022;13:914411. doi: 10.3389/fneur.2022.914411.

Bihariesingh-Sanchit R, Bansie R, Ramdhani N, Mangroo R, Bustamente D, Diaz E, et al. Reduced mortality among COVID-19 ICU patients after treatment with HemoClear convalescent plasma in Suriname. mBio. 2023 Mar;14(2):e03379-22. doi: 10.1128/mbio.03379-22.

Jiang X, et al. Myasthenia gravis exacerbation and myasthenic crisis associated with COVID-19: Case series and literature review. J Neurol. 2020. doi: 10.1007/s10072-021-05823-w.

Roca E, et al. The relationship between myasthenia gravis and COVID-19: A systematic review. Egypt J Neurol Psychiatr Neurosurg. 2021. doi: 10.1186/s41983-022-00516-3.