Clinical and treatment profiles of myasthenic crisis patients in a tertiary hospital in the Philippines: a single-center retrospective study

Myasthenic crisis is a life-threatening complication of myasthenia gravis. Data on its clinical profile and outcomes in resource-limited settings are limited. A retrospective review of pediatric and adult myasthenic crisis patients admitted at Philippine General Hospital from 2015 to 2024 was conducted. Sociodemographic, clinical, treatment, and outcome data were extracted from inpatient charts. Descriptive statistics and Pearson’s chi-square, Fisher’s exact, Wilcoxon rank-sum, and Kruskal–Wallis tests were used to analyze associations between clinical characteristics and outcomes. Eighty-two patients were included, mostly female ( n = 49, 59.8%) with peak onset in the third decade. Infection was the leading precipitant of crisis, while hypertension, diabetes, and tuberculosis were common comorbidities. Nearly all required ventilation (96.3%, median nine days). Mortality was 13.4% ( n = 11), mainly due to sepsis and respiratory failure. Younger age (< 30 years, p = 0.021) was linked to improved survival, whereas absence of intravenous immunoglobulin (IVIG) or therapeutic plasma exchange (TPE) was associated with higher mortality ( p = 0.012). This study provided one of the largest descriptions of myasthenic crisis in the Philippines, demonstrating that infection remains the predominant inciting factor and timely rescue immunotherapy is associated with improved survival. These findings support strengthening access to specialized neuromuscular care and crisis-directed therapies in resource-constrained settings.