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Annali Italiani Di Medicina Interna :... 1988
Review
Topics: Antibodies; Autoimmune Diseases; Humans; Myasthenia Gravis; Receptors, Cholinergic; Thymus Gland
PubMed: 3152864
DOI: No ID Found -
Cureus Nov 2021Myasthenia gravis affects the neuromuscular junction of the skeletal muscles. It results in muscle weakness involving skeletal muscles (diaphragm, extraocular muscles)... (Review)
Review
Myasthenia gravis affects the neuromuscular junction of the skeletal muscles. It results in muscle weakness involving skeletal muscles (diaphragm, extraocular muscles) and myasthenic crisis. Treatment options for myasthenia gravis management have expanded, including azathioprine, corticosteroids, plasma exchange, and tacrolimus. Unfortunately, a few cases of myasthenia gravis don't respond to conventional treatment modalities. Monoclonal antibodies, rituximab (RTX), are novel treatments that have garnered interest as of late due to their efficacy within the patient population presented with refractory form myasthenia gravis. This review aims to showcase how RTX is an effective treatment within different forms of myasthenia gravis. A limited review was performed using databases that include PubMed and Google Scholar. The following keywords were used: "myasthenia gravis," "rituximab," "monoclonal antibody," "anti-AChR antibody," and "refractory myasthenia." The review focused on case reports, human studies, or research surveys based on the inclusion criteria of human studies involving participants more than 18 years of age and published in English literature. Out of 69 articles, 14 were duplicates, and 29 were relevant and met the inclusion criteria. The findings from the study demonstrate that patients with refractory myasthenia gravis responded well to RTX treatment. Furthermore, RTX has been shown to decrease corticosteroid dependence, induce sustained remission, and have a favorable response to anti-MuSK antibody positive myasthenia gravis compared to anti-AChR antibody positive myasthenia gravis. This literature review suggests that patients with refractory myasthenia gravis can benefit from rituximab; however, it has a variable response in different forms of myasthenia gravis.
PubMed: 34909332
DOI: 10.7759/cureus.19416 -
Handbook of Clinical Neurology 2008
Review
Topics: Animals; Antigen-Presenting Cells; Humans; Immune System; Models, Immunological; Myasthenia Gravis
PubMed: 18631843
DOI: 10.1016/S0072-9752(07)01505-9 -
Postgraduate Medical Journal Dec 2004Myasthenia gravis is an autoimmune disorder caused by autoantibodies against the nicotinic acetylcholine receptor on the postsynaptic membrane at the neuromuscular... (Review)
Review
Myasthenia gravis is an autoimmune disorder caused by autoantibodies against the nicotinic acetylcholine receptor on the postsynaptic membrane at the neuromuscular junction and characterised by weakness and fatigability of the voluntary muscles. It has a bimodal peak of incidence with first peak in the third decade and the second peak in the sixth decade. It is probably underdiagnosed in the very old population. Our understanding of the pathogenesis, immunology, and molecular biology of myasthenia gravis has greatly improved in last three decades. It is almost always possible to establish the diagnosis of myasthenia gravis with the current tests. The modern treatment is highly successful and the mortality of treated myasthenia gravis is practically zero. However, there are still important gaps in our knowledge of the origin of myasthenia gravis, the factors that contribute to chronic disease, and the way to cure the disease. In this article the current knowledge of the various aspects of myasthenia gravis are outlined.
Topics: Age of Onset; Diagnosis, Differential; Female; Humans; Myasthenia Gravis; Neuromuscular Junction; Pregnancy; Pregnancy Complications; Prognosis
PubMed: 15579606
DOI: 10.1136/pgmj.2004.018903 -
Prilozi (Makedonska Akademija Na... Jul 2023Transient neonatal myasthenia gravis (TNMG) is a neuromuscular disorder that occurs in infants born from mothers with myasthenia gravis (MG) due to transplacental...
Transient neonatal myasthenia gravis (TNMG) is a neuromuscular disorder that occurs in infants born from mothers with myasthenia gravis (MG) due to transplacental transfer of antibodies against the acetylcholine receptor. TNMG is a rare form occurring in 10-15% of infants born from mothers with MG. We present a case of a newborn with TNMG with generalized hypotonia and respiratory distress. The newborn shows symptoms of hypotonia, weakened reflexes, poor crying, difficult sucking and potentiated tachydyspnea after 24 hours of birth and needs of assisted mechanical ventilation. Based on the mother's positive history of MG and the high titer of mother's (8.43nmol/l) and newborn's (9.088nmol/l) anti-AChR antibodies, TNMG was diagnosed. The baby was treated with assisted mechanical ventilation and neostig-mine until the anti-AChR antibody titer was negative. Adequate management of the newborn resulted in a positive outcome and evident withdrawal of the symptoms. Although TNMG is one of the rare neuromuscular disorders in newborns that can be treated, a multidisciplinary approach in the management of pregnant women with MG and newborns through timely diagnosis and early appropriate treatment, results in successful resolution of this condition.
Topics: Female; Infant, Newborn; Humans; Pregnancy; Myasthenia Gravis, Neonatal; Muscle Hypotonia; Myasthenia Gravis; Receptors, Cholinergic; Mothers
PubMed: 37453109
DOI: 10.2478/prilozi-2023-0036 -
Ryoikibetsu Shokogun Shirizu 2001
Review
Topics: Animals; Autoantibodies; Cholinesterase Inhibitors; Diagnosis, Differential; Exchange Transfusion, Whole Blood; Female; Humans; Infant, Newborn; Maternal-Fetal Exchange; Myasthenia Gravis, Neonatal; Pregnancy; Prognosis; Receptors, Nicotinic; Respiration, Artificial
PubMed: 11596403
DOI: No ID Found -
Journal of the Neurological Sciences Oct 2002Myasthenia gravis is an autoimmune disease associated with antibodies directed to the postsynaptic acetylcholine receptor. These antibodies reduce the number of... (Review)
Review
Myasthenia gravis is an autoimmune disease associated with antibodies directed to the postsynaptic acetylcholine receptor. These antibodies reduce the number of receptors. Autoantibodies against AChR and other muscle antigens can be used for the diagnosis of myasthenia gravis and related disorders. The origin and the role of these antibodies in the disease are discussed. Experimental autoimmune myasthenia gravis, an experimental model closely mimicking the disease, has provided answers to many questions about the role of antibodies, complement macrophages and AChR anchor proteins. Genetically modified anti-AChR antibodies may also be used in the future to treat myasthenia.
Topics: Autoantibodies; Humans; Myasthenia Gravis; Nervous System Autoimmune Disease, Experimental; Receptors, Nicotinic
PubMed: 12220686
DOI: 10.1016/s0022-510x(02)00200-9 -
Seminars in Neurology Mar 1990
Review
Topics: Adrenal Cortex Hormones; Cholinesterase Inhibitors; Humans; Immunosuppression Therapy; Myasthenia Gravis; Thymus Gland
PubMed: 2189183
DOI: 10.1055/s-2008-1041256 -
Clinical Drug Investigation 2011Earlier diagnosis and the availability of effective treatments have reduced the burden of high mortality and severe disability previously associated with myasthenia... (Review)
Review
Earlier diagnosis and the availability of effective treatments have reduced the burden of high mortality and severe disability previously associated with myasthenia gravis (MG). Consequently, the prognosis of MG is now much improved. However, despite extensive knowledge of MG and its aetiology, diagnosing the disease remains problematic and can be delayed because of its nonspecific and fluctuating symptoms, and the management of MG is associated with considerable limitations. Current treatments based on immunomodulation are associated with adverse effects arising from prolonged immune suppression. There is a need for improved awareness among primary caregivers about this relatively rare, but treatable, disease.
Topics: Cholinesterase Inhibitors; Humans; Immunosuppressive Agents; Models, Neurological; Myasthenia Gravis; Thymectomy
PubMed: 21053987
DOI: 10.2165/11584740-000000000-00000 -
Current Allergy and Asthma Reports Jul 2007Myasthenia gravis has changed from being a frequently fatal condition with a reputation little better than motor neuron disease to a generally treatable condition over... (Review)
Review
Myasthenia gravis has changed from being a frequently fatal condition with a reputation little better than motor neuron disease to a generally treatable condition over the previous century. However, the chronic, largely immunosuppressive treatment comes with the major problems of very slow response and of treatment-induced morbidity and mortality. -Myasthenia gravis is a model autoimmune disease of a model physiologic structure, so is well placed for trials of novel treatments with ramifications for autoimmunity generally. There are also good animal models, so specific approaches to reinduction of tolerance can be tested. Hope of future revolutions in treatment should not hinder efforts to better understand currently available therapies and a concerted approach to ameliorate the side effects of treatment.
Topics: Animals; Autoimmunity; Disease Models, Animal; Humans; Immunosuppression Therapy; Motor Neurons; Myasthenia Gravis
PubMed: 17547852
DOI: 10.1007/s11882-007-0044-9