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

This article presents a case study about a young woman with a severe form of myasthenia gravis (MG), a disease that causes muscle weakness. Her condition was so severe that it was considered ‘refractory’, meaning that it didn’t respond well to standard treatments.

The patient had tried several medications, but her symptoms, including difficulty walking and swallowing, kept coming back. She eventually started a new, more effective drug called eculizumab.

Later, she became pregnant. She initially stopped taking eculizumab because little data is available to date on it use during pregnancy, but her symptoms worsened dramatically. After discussing the risks and benefits with her doctors, she decided to restart the medication and continued it throughout her pregnancy and after giving birth.

The key takeaways from this case study are:

• Eculizumab was effective. The patient’s symptoms improved significantly after she restarted the medication.

• The pregnancy was successful. The patient gave birth to a healthy baby. While the baby had a temporary form of MG after birth, which is common in babies born to mothers with the disease, his symptoms were mild and he recovered fully. He is now developing normally.

• More research is needed. This case, along with a few others, suggests that eculizumab may be a safe option for pregnant women with severe MG. However, doctors need more information and longterm data to confirm its safety for both mothers and babies.

The article emphasizes the importance of planning a pregnancy for women with MG to ensure their disease is well-controlled beforehand, which can help prevent complications.

Article available at: https://doi.org/10.7573/dic.2025-5-7