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Efgartigimod and Steroid Pulse Therapy as an Early Fast-acting Treatment Strategy for Anti-MUSK Myasthenic Crisis

Year: 2026

Type: article

Abstract: We present the case of an 83-year-old Japanese woman with anti-muscle-specific kinase (MUSK)-positive myasthenia gravis (MG) who rapidly progressed from ocular symptoms to a myasthenic crisis requiring mechanical ventilation. Immediate intervention with efgartigimod, a neonatal Fc receptor (FcRn) antagonist, combined with steroid pulse therapy, facilitated the prompt extubation and recovery of the patient. Notably, clinical remission was achieved without plasma exchange or intravenous immunoglobulin administration, and the patient was successfully maintained on tacrolimus without the use of oral corticosteroids. This case suggests that efgartigimod may be effective in acute anti-MUSK MG exacerbations, positioning FcRn inhibition as a promising alternative to conventional fast-acting rescue therapies.

Source: Internal Medicine

DOI: 10.2169/internalmedicine.7499-26

Authors: Joe Senda, Hiroto Kato, Rikuko Kamiya-Goto, Taiki Fukushima, Yoshinobu Amakusa, Yuki Fukami, Yasuhiro Ogawa, Katsuhiro Kawaguchi, Masahisa Katsuno

Institutions: Komaki City Hospital, Nagoya University Hospital, Nagoya University

Language: English

Topic: Myasthenia Gravis and Thymoma

Subfield: Clinical Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7211916878

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