Antiphospholipid Antibody Syndrome, Myasthenia Gravis, and Diabetes Mellitus: A Mosaic of Autoimmune Entities in A Pregnant Patient

MEDICINE Research project

This is a case of a 34-year old, Gravida 5 Para 0 (0040), Pregnancy Uterine 36 weeks, in breech presentation, who presented with poor obstetrical history, she was diagnosed with Antiphospholipid antibody Syndrome. Myasthenia Gravis, and Gestational Diabetes Mellitus-Insulin requiring, and was admitted due to preterm labor. The patient was given the standard management for these clinical entities. For APAS low molecular weight and low dose aspirin, for myasthenia Gravis Pyridostigmine, and for Gestational Diabetes Mellitus, fetal suerveillance via weekly BPS and NST, CBG monitoring, and insulin. The patient was tocolysed with calcium channel blocker (Nifedine) until she reach 38 weeks wherein she then underwent low segment cesarean section which resulted to ag ood baby outcome. APAS and Myasthenia Gravis, the two being autoimmune in origin, are due to the presence of autoantiboides. Therefore the possibilility that her Gestational Diabetes Mellitus could also be of autoimmune origin was considered.