A Case of Myasthenia Gravis Treated with Immunoadsorption Therapy before Liver Resection

Abstract

  A 54-year-old female with myasthenia gravis was scheduled for liver resection. Since she had had bulbar palsy and respiratory distress prior to the surgery, we treated her with immunoadsorption before surgery to improve her symptoms. General anesthesia was induced with propofol and rocuronium and sugammadex was given after the surgery. Twelve hours after extubation, recurrence of dyspnea required intravenous acetylcholinesterase inhibitor. Because the duration of clinical improvement of immunoadsorption is limited, patients with myasthenia gravis must be closely monitored after surgery.