An ocular myasthenia gravis attack after oral pyrantel pamoate: An unusual case report

Medicine (Baltimore). 2019 Jul;98(27):e16321. doi: 10.1097/MD.0000000000016321.

Abstract

Rationale: Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction that can be triggered by anticholinergic agents.

Patient concerns: We present a 4-year-old female patient who was admitted to the outpatient clinic. She complained of drooped eyelids, which first appeared 2 days after taking a 200 mg dose of pyrantel pamoate. Past medical history is negative.

Diagnoses and treatment: She was hospitalized with a diagnosis of ocular type MG, and pyridostigmine (40 mg/day) treatment was started.

Outcomes: The patient recovered, and subsequently, the treatment dose was tapered.

Conclusion: Pyrantel is an antihelminthic that acts as an agonist of nicotinic acetylcholine receptors (AChRs) of nematodes and exerts its therapeutic effects by depolarizing their muscle membranes. Consequently, there may be an association between pyrantel pamoate and MG.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Antinematodal Agents / administration & dosage
  • Antinematodal Agents / adverse effects*
  • Child, Preschool
  • Female
  • Humans
  • Myasthenia Gravis / chemically induced*
  • Myasthenia Gravis / diagnosis
  • Myasthenia Gravis / therapy
  • Pyrantel Pamoate / administration & dosage
  • Pyrantel Pamoate / adverse effects*

Substances

  • Antinematodal Agents
  • Pyrantel Pamoate