Management of refractory generalized myasthenia gravis with eculizumab during pregnancy and puerperium: a case report

Myasthenia gravis (MG) mostly affects women of childbearing age. Since the disease course may be affected during pregnancy and postpartum, monitoring and appropriate treatment of MG in pregnant women are crucial. Current treatment options for pregnant women with refractory MG are limited by possible teratogenicity and inadequate lactation data. This case report describes a successful pregnancy in a patient who received eculizumab for refractory generalized MG that was difficult to manage during the pre-pregnancy period. We also report the experience of preterm labour and neonatal MG and the 1-year follow-up of the neonate. Considering the risk-benefit balance, eculizumab can be recommended during pregnancy and postpartum, especially in women with refractory generalized MG.