Select Intensive Care Unit Resources May Be Effective in Myasthenia Gravis Care

Myasthenia gravis (MG) can be managed with intensive care unit (ICU) resources, according to a 20-year retrospective study published in the Southern African Journal of Critical Care.

Information about the clinical characteristics and outcomes of patients with MG admitted to the ICU is limited, the researchers noted.

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A team of researchers conducted a retrospective study in patients with MG admitted to the multidisciplinary ICU of the Charlotte Maxeke Johannesburg Academic Hospital in South Africa between 1998 and 2017.

During this time period, 34 patients with MG, who were 16 to 66 years of age were admitted to the ICU of the hospital. Of these 24 were women and 10 were men. A total of 4 patients were HIV-positive at the time of admission. 

The mean length of stay in the ICU ranged between 1 and 115 days, or nearly 4 months. 

Two patients were diagnosed with MG during their time at the ICU following failure to wean from the ventilator. 

The researchers reported that the majority of patients (64.7%) were intubated and ventilated at the time of admission to the ICU. 

Morbidities included self-extubation, aspiration pneumonia, and iatrogenic pneumothorax. 

A little more than a third of patients (35.3%) had a history of thymectomy. Other treatments that patients received included corticosteroids, pyridostigmine, plasmapheresis, azathioprine, and intravenous immunoglobulin. 

The overall mortality rate of the patients in the ICU was 5.9%.

“The morbidity and mortality rates of patients with MG admitted to ICU were low,” the researchers concluded. “Despite the acute risk of mortality associated with severe exacerbations of MG, the overall prognosis was favorable.”

MG is a rare but chronic neurologic disease characterized by generalized fatiguability and muscle weakness. Some patients experience myasthenic crises or severe generalized weakness of the respiratory muscles and require emergency treatment.

This article originally appeared on Rare Disease Advisor