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Asia-Pacific Journal of Ophthalmology... 2018Myasthenia gravis is a relatively common neuromuscular disorder, with ocular myasthenia gravis being a subset defined as myasthenia gravis limited to the orbicularis,... (Review)
Review
Myasthenia gravis is a relatively common neuromuscular disorder, with ocular myasthenia gravis being a subset defined as myasthenia gravis limited to the orbicularis, levator, and extraocular muscles. Patients with ocular myasthenia gravis can have disabling diplopia or functional blindness from ptosis and in most cases treatment is required. Like generalized myasthenia gravis, there are a variety of treatments available that include pyridostigmine, immunosuppression, intravenous immunoglobulin, plasmapheresis, thymectomy, lid crutches, ptosis surgery, and extraocular muscle surgery. Unfortunately, there is limited data on the use of individual treatments in ocular myasthenia gravis and no data comparing treatments. Using a combination of available data on treatment of generalized myasthenia gravis, data on treatment of ocular myasthenia gravis, best practices, and clinical experience we will provide a rational framework for treatment of ocular myasthenia gravis.
Topics: Eye Movements; Humans; Immunosuppression Therapy; Myasthenia Gravis; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Plasmapheresis; Prognosis; Visual Acuity
PubMed: 30044061
DOI: 10.22608/APO.2018301 -
Cureus Sep 2020Myasthenia gravis (MG) is a rare autoimmune neuromuscular junction disorder, and thyroid disorder is a disorder involving the thyroid receptor, of which Graves' disease... (Review)
Review
Myasthenia gravis (MG) is a rare autoimmune neuromuscular junction disorder, and thyroid disorder is a disorder involving the thyroid receptor, of which Graves' disease (GD) is the most common autoimmune thyroid disorder, in which antibodies develop against thyroid receptors. Both may have similar clinical features. In myasthenia gravis, autoimmune antibodies develop against postsynaptic neuromuscular junction disrupting the neuromuscular transmission, resulting in fluctuating muscle weakness and fatigue. It is a disease of young women and older men. The two pathologies may coexist in a patient or can precede one another. Graves' disease (GD) among thyroid diseases is most often associated with MG. Similarities in clinical features lead to difficulty in distinguishing MG and GD. Despite the standard treatment of myasthenia gravis, including steroids, acetylcholinesterases, rituximab, immunosuppressants, and thymectomy, there is still an increased number of relapses and myasthenia crisis. Eculizumab and plasmapheresis are the two new treatment options for MG, with supporting evidence of marked improvement in recent studies. Myasthenia gravis and Graves' disease have a see-saw relationship. Treating one pathology may worsen the other, so physicians should always consider MG as a differential in patients of hyperthyroidism presenting with new symptoms of fatigue or respiratory failure or neuromuscular weakness. In this comprehensive review article, we tried to establish an association between myasthenia gravis and Graves' disease (GD) by exploring currently available literature from PubMed. However, more studies need to be done to establish an association between pathologies.
PubMed: 33042687
DOI: 10.7759/cureus.10248 -
Frontiers in Immunology 2020
Topics: Animals; Autoantibodies; Autoimmunity; Humans; Immunosuppressive Agents; LDL-Receptor Related Proteins; Myasthenia Gravis; Receptor Protein-Tyrosine Kinases; Receptors, Cholinergic
PubMed: 32983085
DOI: 10.3389/fimmu.2020.01688 -
Glasgow Medical Journal Oct 1952
Topics: Humans; Myasthenia Gravis
PubMed: 13021551
DOI: No ID Found -
European Journal of Case Reports in... 2021Myasthenia gravis is a rare autoimmune disease caused by autoantibodies directed against the synapses of the neuromuscular junction.
INTRODUCTION
Myasthenia gravis is a rare autoimmune disease caused by autoantibodies directed against the synapses of the neuromuscular junction.
PATIENT AND METHODS
We report the case of a young patient with myasthenia gravis associated with Hodgkin's lymphoma.
RESULTS
A 22-year-old patient presented with a 2-month history of severe weakness associated with muscle fatigability and intermittent ptosis without dysphonia or respiratory signs. Clinical examination revealed generalized myasthenia. The EMG did not show post-synaptic block, and anti-acetylcholine receptor antibodies were elevated at 3 nmol/l (normal ≤0.3 nmol/l). CT of the thorax showed an anterior medial mass. Immunohistochemistry of the mass revealed mixed cellularity Hodgkin's lymphoma.
CONCLUSION
The association of lymphomas with myasthenia gravis has been rarely reported.
LEARNING POINTS
Myasthenia gravis is an autoimmune disease of the neuromuscular junction and can be associated with malignant haemopathy.The coexistence of myasthenia and Hodgkin's lymphoma is very rare.This association is a therapeutic challenge.
PubMed: 33987113
DOI: 10.12890/2021_002375 -
Neurologic Clinics May 2018In this article we provide an overview of health-related outcome measurement-to better understand what different outcomes used in myasthenia actually measure-and to... (Review)
Review
In this article we provide an overview of health-related outcome measurement-to better understand what different outcomes used in myasthenia actually measure-and to provide some guidance when choosing measures based on the clinical context and question. In myasthenia, the most commonly used outcome measures are aimed at assessing the signs and symptoms. In this review, we provide a summary of the most commonly used outcome measures. We discuss instruments that gauge disease overall health impact, such as on disability and quality of life. Finally, we discuss other relevant outcomes such as steroid-sparing effects and the role of surrogate markers.
Topics: Disability Evaluation; Humans; Minimal Clinically Important Difference; Myasthenia Gravis
PubMed: 29655453
DOI: 10.1016/j.ncl.2018.01.006 -
Cleveland Clinic Journal of Medicine Feb 2023
Topics: Humans; Myasthenia Gravis; Physicians
PubMed: 36724915
DOI: 10.3949/ccjm.90b.02023 -
European Respiratory Review : An... Dec 2021Thymic tumours are rare thoracic malignancies, that may be aggressive and difficult to treat. The pillars of the management include pathological review, consideration of... (Review)
Review
Thymic tumours are rare thoracic malignancies, that may be aggressive and difficult to treat. The pillars of the management include pathological review, consideration of differential diagnoses, staging and multidisciplinary discussion. Assessment of resectability is key to drive the treatment sequencing. Association with autoimmune diseases, especially myasthenia gravis, is observed, which impacts the oncological management. Networks are being built at the national and international levels. This article provides an overview of the most recent findings in the diagnosis, staging, histology, and management strategies of thymic tumours.
Topics: Diagnosis, Differential; Humans; Myasthenia Gravis; Retrospective Studies; Thymoma; Thymus Neoplasms
PubMed: 34670805
DOI: 10.1183/16000617.0394-2020 -
Cureus Jul 2020This study aimed to review studies focused on the affective comorbidities associated with myasthenia gravis and to determine the extent to which neuromuscular treatment... (Review)
Review
This study aimed to review studies focused on the affective comorbidities associated with myasthenia gravis and to determine the extent to which neuromuscular treatment modalities address non-somatic aspects of autoimmune myasthenia gravis. Depression, anxiety, and emotional hyperactivity can aggravate myasthenia gravis, hinder accurate diagnoses, and presumably influence overall health-related quality of life. Studies were identified using PubMed Medline and Web of Science to assess the effects of psychological factors on myasthenia gravis, encompassing 49 years of research worldwide. After analysis, approximately 6,060 patients from 32 studies worldwide between 1971 and 2020 were included. Standard-of-care approaches to diagnosis and treatment continue to under-appreciate the prevalence or impact of mood disorders in myasthenia gravis. The majority of studies evaluated demonstrated an association between myasthenia gravis and mood disorders. However, the initiative to detect and treat affective comorbidities probably remains suboptimal. Although treatments for the somatic effects of myasthenia gravis have evolved over the past century, the paradigm of clinical practice has yet to adequately address the management of psychological impacts on the disease. This review is hoped to raise the necessary awareness in this regard.
PubMed: 32802619
DOI: 10.7759/cureus.9184 -
Nihon Rinsho Men'eki Gakkai Kaishi =... 2017
Topics: Aged; Antineoplastic Agents, Immunological; Autoantibodies; Humans; Myasthenia Gravis; Myocarditis; Myositis; Neuromuscular Junction; Nivolumab; Periodicity; Receptors, Cholinergic
PubMed: 29176295
DOI: 10.2177/jsci.40.263b