Efgartigimod and Steroid Pulse Therapy as an Early Fast-acting Treatment Strategy for Anti-MUSK Myasthenic Crisis
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.
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BibTeX
@article{senda2026efgartigimod,
title = {{Efgartigimod and Steroid Pulse Therapy as an Early Fast-acting Treatment Strategy for Anti-MUSK Myasthenic Crisis}},
author = {Joe Senda and Hiroto Kato and Rikuko Kamiya-Goto and Taiki Fukushima and Yoshinobu Amakusa and Yuki Fukami and Yasuhiro Ogawa and Katsuhiro Kawaguchi and Masahisa Katsuno},
journal = {Internal Medicine},
year = {2026},
month = sep,
doi = {10.2169/internalmedicine.7499-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7499-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Efgartigimod and Steroid Pulse Therapy as an Early Fast-acting Treatment Strategy for Anti-MUSK Myasthenic Crisis
AU - Joe Senda
AU - Hiroto Kato
AU - Rikuko Kamiya-Goto
AU - Taiki Fukushima
AU - Yoshinobu Amakusa
AU - Yuki Fukami
AU - Yasuhiro Ogawa
AU - Katsuhiro Kawaguchi
AU - Masahisa Katsuno
PY - 2026
DA - 2026/09/08
JO - Internal Medicine
DO - 10.2169/internalmedicine.7499-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7499-26/_article
AB - 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.
SN - 1349-7235
SN - 0918-2918
ER -