A case of anti-MuSK positive myasthenia gravis

Anti-musk myasthenia gravis (mg) is a rare autoimmune neuromuscular junction disorder with poor response to conventional management of mg. we're reporting a case with typical presentation and clinical course of this disorder. 28-year-old lady presented with prominent oculobulbar,proximal muscle and respiratory muscle progressively worsened for the past 8 months with demonstrable fatigability with requiring ventilatory support. she responded poorly to intravenous immunoglobulin (ivig),conventional immunosuppressive therapy but improved remarkably with plasmapharesis. her acetylcholine receptor antibody was negative and anti-musk antibodies turn out to be positive (1.15nmol/l). the clinical presentation and the clinical course of this patient corresponds to other reported anti-musk positive mg cases. plasmapharesis appears to be an effective treatment for this group of patients in mg crisis.