DOI: https://doi.org/10.14710/jai.v0i0.83434

The Role of CRRT in Optimizing the Management of Septic Shock in Patients with Myasthenia Gravis Improves Outcomes

1Department of Anesthesiology and Intensive Care, Universitas Indonesia, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia

2Department of Anesthesiology and Intensive Care, Universitas Indonesia, Fatmawati General Hospital, Jakarta, Indonesia

Received: 31 Mar 2026; Revised: 13 Apr 2026; Accepted: 21 Apr 2026; Available online: 23 Apr 2026.
Open Access Copyright 2026 JAI (Jurnal Anestesiologi Indonesia)
Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

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Abstract

Background: Septic shock is a life-threatening condition arising from an uncontrolled host response to infection, leading to organ dysfunction and high mortality. Patients with myasthenia gravis are more susceptible to respiratory infections, particularly pneumonia, which can aggravate their clinical condition and increase the risk of severe complications.

Case: We report a case of a 47-year-old woman with a known history of myasthenia gravis who developed septic shock secondary to pneumonia, accompanied by acute kidney injury (AKI). The patient presented with respiratory distress and hemodynamic instability requiring mechanical ventilation and vasopressor support. She was managed with a comprehensive approach including fluid resuscitation, broad-spectrum antibiotics, ventilatory support, and continuous renal replacement therapy (CRRT). Immunomodulatory therapies such as plasmapheresis or intravenous immunoglobulin (IVIG) were not administered.

Discussion: During the course of treatment, the patient showed gradual clinical improvement, as indicated by stabilization of hemodynamic status, correction of metabolic and electrolyte imbalances, recovery of renal function, and successful weaning from mechanical ventilation. The improvement observed may be related to adequate control of the underlying infection and optimization of organ support, including the use of CRRT, which may help maintain metabolic stability and contribute to the removal of inflammatory mediators. This case also suggests that in certain clinical settings, management focused on the underlying cause of deterioration may be sufficient without immediate use of immunomodulatory therapy.

Conclusion: Comprehensive management of septic shock, including infection control, hemodynamic stabilization, and organ support with CRRT, may lead to favorable clinical outcomes in patients with myasthenia gravis. Further studies are needed to better define the role of CRRT as an adjunctive therapy in this context.

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Keywords: CRRT; myasthenia gravis; plasmapheresis; pneumonia; septic shock

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Section: Case Reports
Language : EN
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