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Myasthenia gravis and pregnancy: pressing time for best practice guidelines
  1. Paul Maddison
  1. Correspondence to Dr Paul Maddison, Department of Neurology, Nottingham University Hospitals, Queen's Medical Centre Campus, Nottingham NG7 2UH, UK; paul.maddison{at}nhs.net

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Simple consensus guidelines should lead to uniform, consistent management of myasthenia gravis in pregnancy

As is well known, the placenta is an immune privileged site, adapted to protect the developing fetus from potentially harmful immune effects from the host. In myasthenia gravis (MG), an organ-specific autoimmune disorder of neuromuscular transmission, antibodies specific for the acetylcholine receptor (AChR), principally of the immunoglobulin (Ig)G subclass,1 cause muscle weakness. Despite its immune protective role, the placenta allows these specific IgG antibodies to cross into the developing fetal circulation, affecting neuromuscular transmission in the baby, sometimes seen as transient myasthenic signs in the newborn. Rarely, mothers with MG who harbour …

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