17,078 results match your criteria Myasthenia Gravis


Seizures as a clinical manifestation in somatic autoimmune disorders.

Seizure 2018 Dec 5;64:59-64. Epub 2018 Dec 5.

Stichting Epilepsie Instellingen Nederland (SEIN), Achterweg 5, Heemstede, 2103SW, Netherlands; NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, London, WC1N 3BG, United Kingdom; Chalfont Centre for Epilepsy, Chalfont St Peter, Bucks, SL9 0RJ, United Kingdom.

The risk of epileptic seizures seems increased in several systemic autoimmune disorders including systemic lupus erythematosus, type 1 diabetes mellitus, myasthenia gravis, celiac disease, rheumatoid arthritis, Hashimoto's encephalopathy, psoriasis, multiple sclerosis, neuromyelitis optica, and bullous pemphigoid. Immune dysfunction may be partly responsible for this association. Elevated levels of pro-inflammatory cytokines, autoantibodies seen in these autoimmune disorders and antibodies against neuronal antigens may contribute to the etiopathogenesis of seizures and epilepsy associated to immune conditions. Read More

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http://dx.doi.org/10.1016/j.seizure.2018.11.012DOI Listing
December 2018

Autoimmune diseases in autoimmune atrophic gastritis.

Acta Biomed 2018 Dec 17;89(8-S):100-103. Epub 2018 Dec 17.

Endoscopy Unit, Departement of Surgery, ULSS7-Pedemontana, Santorso Hospital, Santorso (VI), Italy.

Autoimmune diseases, characterized by an alteration of the immune system which results in a loss of tolerance to self antigens often coexist in the same patient. Autoimmune atrophic gastritis, characterized by the development of antibodies agains parietal cells and against intrinsic factor, leads to mucosal destruction that affects primarily the corpus and fundus of the stomach. Autoimmune atrophic gastritis is frequently found in association with thyroid disease, including Hashimoto's thyroiditis, and with type 1 diabetes mellitus, Other autoimmune conditions that have been described in association with autoimmune atrophic gastritis are Addison's disease, chronic spontaneous urticaria, myasthenia gravis, vitiligo, and perioral cutaneous autoimmune conditions, especially erosive oral lichen planus. Read More

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December 2018

ISMP Adverse Drug Reactions: Lithium-Induced Cardiomyopathy Fixed Drug Eruption Due to Cetirizine, Levocetirizine, and Hydroxyzine Nivolumab-Induced Myasthenia Gravis Nivolumab-Induced Cholangitic Liver Disease Torsade de Pointes Caused by Psychiatric Polypharmacy Trichotillomania Associated With Aripiprazole.

Hosp Pharm 2018 Dec 27;53(6):371-375. Epub 2018 Aug 27.

Temple University School of Pharmacy, Philadelphia, PA, USA.

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration's (FDA) MedWatch program (800-FDA-1088). If you have reported an interesting, preventable ADR to MedWatch, please consider sharing the account with our readers. E-mail Dr. Read More

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http://dx.doi.org/10.1177/0018578718795225DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293386PMC
December 2018

Modified Buzhong Yiqi decoction for myasthenia gravis: A systematic review protocol.

Medicine (Baltimore) 2018 Dec;97(50):e13677

Department of Paediatrics, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.

Background: Myasthenia gravis (MG) is an autoimmune disease caused by the transmission of dysfunction in the neuromuscular junction, manifesting partial or systemic skeletal muscle weakness and fatigue, which are exacerbated by activities and relieved after rest. Currently, the conventional therapy is applying cholinesterase inhibitors, steroids, immunosuppressant, and thymectomy. However, these drugs have obvious side effects. Read More

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http://dx.doi.org/10.1097/MD.0000000000013677DOI Listing
December 2018

Reversible spontaneous EMG activity during myasthenic crisis: Two case reports.

eNeurologicalSci 2019 Mar 20;14:16-18. Epub 2018 Nov 20.

Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.

Background: Myasthenia Gravis (MG) is an antibody-mediated autoimmune neuromuscular disorder, clinically presenting with fatigable variable muscle weakness. Typical electrodiagnostic findings are a decremental response to repetitive nerve stimulation with post-exercise facilitation, and motor unit instability expressed as increased jitter on single fibre-EMG. Presence of spontaneous activity on standard EMG is traditionally considered inconsistent with a diagnosis of MG and would direct the differential diagnosis towards a primary denervating or usually inflammatory myopathic process. Read More

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http://dx.doi.org/10.1016/j.ensci.2018.11.024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6275166PMC

Non-invasive evaluation of sudomotor function in patients with myasthenia gravis.

Neurophysiol Clin 2018 Dec 13. Epub 2018 Dec 13.

Department of Neurosciences and Mental Health, Hospital de Santa Maria-CHLN, avenue Professor-Egas-Moniz, 1648-028 Lisbon, Portugal; IMM and Institute of Physiology, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.

Objectives: Myasthenia gravis (MG) is an autoimmune disease associated with antibodies against the nicotinic muscle acetylcholine receptor (AChR) at the neuromuscular junction. Dysautonomia has been previously described in MG. Electrochemical skin conductance (ESC), assessed by Sudoscan, is a non-invasive method that allows evaluation of sudomotor function. Read More

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http://dx.doi.org/10.1016/j.neucli.2018.12.002DOI Listing
December 2018

Italian recommendations for diagnosis and management of congenital myasthenic syndromes.

Neurol Sci 2018 Dec 15. Epub 2018 Dec 15.

Neurology IV - Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Via Celoria 11, 20133, Milan, Italy.

Congenital myasthenic syndromes (CMS) are genetic disorders due to mutations in genes encoding proteins involved in the neuromuscular junction structure and function. CMS usually present in young children, but perinatal and adult onset has been reported. Clinical presentation is highly heterogeneous, ranging from mild symptoms to severe manifestations, sometimes with life-threatening respiratory episodes, especially in the first decade of life. Read More

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http://link.springer.com/10.1007/s10072-018-3682-x
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http://dx.doi.org/10.1007/s10072-018-3682-xDOI Listing
December 2018
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Alanine-Scanning Mutagenesis of α-Conotoxin GI Reveals the Residues Crucial for Activity at the Muscle Acetylcholine Receptor.

Mar Drugs 2018 Dec 13;16(12). Epub 2018 Dec 13.

Key Laboratory of Tropical Biological Resources, Ministry of Education, Key Lab for Marine Drugs of Haikou, Hainan University, Haikou 570228, Hainan, China.

Recently, the muscle-type nicotinic acetylcholine receptors (nAChRs) have been pursued as a potential target of several diseases, including myogenic disorders, muscle dystrophies and myasthenia gravis, etc. α-conotoxin GI isolated from selectively and potently inhibited the muscle-type nAChRs which can be developed as a tool to study them. Herein, alanine scanning mutagenesis was used to reveal the structure⁻activity relationship (SAR) between GI and mouse α1β1δε nAChRs. Read More

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http://dx.doi.org/10.3390/md16120507DOI Listing
December 2018
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A case of YY1-associated syndromic learning disability or Gabriele-de Vries syndrome with myasthenia gravis.

Am J Med Genet A 2018 Dec 14. Epub 2018 Dec 14.

Department of Neurology, Mayo Clinic, Mayo Clinic, Scottsdale, Arizona.

Exome sequencing is being used increasingly to evaluate patients with intellectual disability. YY1 is a ubiquitously distributed transcription factor belonging to the GLIKruppel class of zinc finger proteins recently recognized as the causative gene in 23 patients for the Gabriele-de Vries syndrome. We report a new case with similar features and a novel variant in YY1, in a region of the gene, which has not previously been reported. Read More

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http://dx.doi.org/10.1002/ajmg.a.40626DOI Listing
December 2018
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Pulmonary embolism caused by myasthenia gravis: A case report.

Medicine (Baltimore) 2018 Dec;97(49):e13578

Department of Respiratory Medicine, Qinghai University Affiliated Hospital, Xining, China.

Rationale: Pulmonary embolism (PE) is a relatively common disease; however, myasthenia gravis leading to PE has been rarely reported in the literature. We report a case of PE in a patient with myasthenia gravis and discuss the possible mechanism underlying the development of PE. We hypothesize that inflammatory mediators may lead to endothelial injury, resulting in PE or deep venous thrombosis (DVT) in patients with myasthenia gravis. Read More

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http://dx.doi.org/10.1097/MD.0000000000013578DOI Listing
December 2018

Asymmetric pattern in generalized myasthenia gravis: A case report.

Medicine (Baltimore) 2018 Dec;97(49):e13460

Federal University of Rio de Janeiro.

Rationale: Myasthenia gravis (MG) is an uncommon autoimmune disease mediated by antibodies that attack the postsynaptic acetylcholine receptors (AchRs) at the neuromuscular junction, causing fluctuating muscle weakness, aggravated with use, and relieved with rest.

Patient Concerns: A 32-year-old woman with a diagnosis of MG based on clinical findings, eletroneuromyography, and brain magnetic resonance imaging (MRI) was admitted to our hospital with dysphagia, dysphonia, diplopia, and intense weakness, associated with a 2-day viral gastroenteritis.

Diagnoses: Physical examination revealed globally reduced deep tendon reflexes, and tetraparesis, with muscle strength grade 4 in the left limbs and grade 2 in the right limbs. Read More

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http://dx.doi.org/10.1097/MD.0000000000013460DOI Listing
December 2018

Survey of owners on population characteristics, diagnosis, and environmental, health, and disease associations in dogs with megaesophagus.

Authors:
Jillian M Haines

Res Vet Sci 2018 Nov 30;123:1-6. Epub 2018 Nov 30.

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, PO Box 647060, Pullman, WA 99164-7060, USA. Electronic address:

Megaesophagus affects dogs worldwide but limited information is available regarding its characteristics in the general population of dogs. The objectives of this study were to provide information on a large population of dogs diagnosed with megaesophagus in regards to population characteristics, medical and family history, diagnosis, concurrent disease, and predisposing factors. A link to a web-based survey was provided on megaesophagus support websites and 838 eligible surveys were evaluated. Read More

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http://dx.doi.org/10.1016/j.rvsc.2018.11.026DOI Listing
November 2018
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Coexistence of Systemic Lupus Erythematosus and Myasthenia Gravis: An Unusual Case of Polyautoimmunity.

Reumatol Clin 2018 Dec 3. Epub 2018 Dec 3.

Unidad de Reumatología, Hospital Universitario San Ignacio, Bogotá, Colombia.

The relevance of polyautoimmunity, defined as the presence of 2or more autoimmune diseases in the same individual, is one of the issues not yet elucidated in medical practice. The coexistence of myasthenia gravis (MG) and systemic lupus erythematosus (SLE) is a clinical challenge due to the possible differential diagnoses of muscle involvement in patients with SLE. We present the case of a patient who came to the emergency room of Hospital Universitario San Ignacio in Bogotá, Colombia, with a previous diagnosis of SLE, who developed acute weakness in the context of a systemic infection, with a clinical and electrophysiological diagnosis of MG. Read More

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http://dx.doi.org/10.1016/j.reuma.2018.08.013DOI Listing
December 2018

[Under-diagnosis of neuromuscular diseases in patients of 80 years and older].

Rev Esp Geriatr Gerontol 2018 Dec 3. Epub 2018 Dec 3.

Servicio de Geriatría, Hospital Universitario de la Santa Creu, Vic, Barcelona, España; Grupo de Investigación en Cronicidad de la Catalunya Central (C3RG), España.

Myasthenia gravis (MG), amyotrophic lateral sclerosis and Guillain-Barre syndrome (GBS) have been classically considered as exceptional or unusual diseases in people with a geriatric profile. Over the past 25 years, several population-based studies have been conducted in the Osona area (Barcelona), which, for the first time, has led to describing the high global incidences in the elderly, especially those over 80 years-old. The results suggest the possibility of underdiagnosis of these neuromuscular diseases in the elderly, a fact that could be especially relevant in the case of MG and GBS, since they are 2potentially reversible entities with high mortality in the event of underdiagnosis and absence of treatment. Read More

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http://dx.doi.org/10.1016/j.regg.2018.10.004DOI Listing
December 2018

Traditional Korean Medicine Treatment for Patients with Wilting Disorder: A Literature Review of In Vivo Studies.

Evid Based Complement Alternat Med 2018 13;2018:5601846. Epub 2018 Nov 13.

Department of Acupuncture & Moxibustion, Kyung Hee University Hospital at Gangdong, 149 Sangil-dong, Gangdong-gu, Seoul 134-727, Republic of Korea.

Wilting disorder is an abnormal condition characterized by weakness and paralysis of the upper and lower extremities. Pathogenesis and treatment target of the disorder are unclear; hence, allopathic treatment is generally used to relieve the symptoms. To investigate the treatment mechanism and effect of Traditional Korean Medicine (TKM) in patients with wilting disorder, we reviewed in vivo studies that focused on the effect of TKM on the main symptoms of wilting disorder and treatment of the diseases that can cause these symptoms. Read More

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http://dx.doi.org/10.1155/2018/5601846DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6260545PMC
November 2018

A Simple, Rapid and Non-Radiolabeled Immune Assay to Detect Anti-AChR Antibodies in Myasthenia Gravis.

Lab Med 2018 Dec 7. Epub 2018 Dec 7.

Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.

Objective: To assess the practicality of dot-blot testing for rapid and sensitive detection of the antiacetylcholine receptor (anti-AChR) antibodies in myasthenia gravis (MG).

Methods: In this case-control study, we tested serum specimens of 85 patients with MG, 85 healthy control individuals, and 85 patients without MG who have other autoimmune and neurological illnesses. All the serum specimens were tested for anti-AChR antibodies using 3 assays: in-house enzyme-linked immunosorbent assay (ELISA), the dot-blot assay, and commercial ELISA. Read More

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http://dx.doi.org/10.1093/labmed/lmy038DOI Listing
December 2018

Takotsubo Cardiomyopathy Mimicking Myocardial Infarction in a Man with Myasthenic Crisis: A Case Report and Literature Review.

Am J Med Case Rep 2018 11;6(9):184-188. Epub 2018 Oct 11.

Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, N.Y, U.S.A-11203.

Takotsubo Cardiomyopathy is a syndrome characterized by transient and reversible regional myocardial dysfunction in the absence of obstructive coronary artery disease classically resulting in ventricular apical ballooning. It has a strong female predominance with onset generally in seventh decade of life, with hypothesized pathophysiology related to excess of catecholaminergic stimulation, particularly during episodes of physical or emotional stress. Takotsubo cardiomyopathy has been previously reported during myasthenic crisis, the acute deterioration of myasthenia gravis typically involving respiratory failure that is also associated with physical or emotional stress. Read More

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http://dx.doi.org/10.12691/ajmcr-6-9-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6282804PMC
October 2018

Resolution of primary ovarian insufficiency after corticosteroid administration in a myasthenia gravis patient: Report and minireview of the literature.

Neurol India 2018 Nov-Dec;66(6):1807-1810

Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

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http://dx.doi.org/10.4103/0028-3886.246274DOI Listing
December 2018
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Neurotoxicity of the antibiotics: A comprehensive study.

Neurol India 2018 Nov-Dec;66(6):1732-1740

Department of Neurosurgery, Tabriz University of Medical Sciences, Tabriz, Iran.

Antibiotics are among the most widely used medications in clinical settings. Seizures, encephalopathy, optic neuropathy, peripheral neuropathy, and exacerbation of myasthenia gravis are important examples of neurotoxic adverse events associated with the use of antibiotics. This article aims to review the most common and important neurotoxic adverse effects associated with various antibiotics routinely used in a clinical setting. Read More

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http://dx.doi.org/10.4103/0028-3886.246258DOI Listing
December 2018
2 Reads

Ice Pack Test - An Useful Bedside Test to Diagnose Myasthenia Gravis.

QJM 2018 Dec 4. Epub 2018 Dec 4.

Neurology Unit, Department of Internal Medicine, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia.

Myasthenia gravis is a common autoimmune neurological disorder that is frequently encountered in our daily practice. Its presentation can vary from ocular myasthenia, generalized myasthenia to myasthenia crisis. Diagnosing a myasthenia crisis is especially challenging in an intubated patient. Read More

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http://dx.doi.org/10.1093/qjmed/hcy284DOI Listing
December 2018
2 Reads

Critical Care of Neuromuscular Disorders.

Continuum (Minneap Minn) 2018 Dec;24(6):1753-1775

Purpose Of Review: Weakness is a common reason patients are seen in neurologic consultation. This article reviews the differential diagnosis of neuromuscular disorders in the intensive care unit (ICU), discusses the intensive care needs and evaluation of respiratory failure in patients with neuromuscular disorders, and provides a practical guide for management.

Recent Findings: Although primary neuromuscular disorders used to be the most common cause for weakness from peripheral nervous system disease in the ICU, a shift toward ICU-acquired weakness is observed in today's clinical practice. Read More

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http://dx.doi.org/10.1212/CON.0000000000000682DOI Listing
December 2018
5 Reads

Clinical features of laryngeal myasthenia gravis: A case series.

Am J Otolaryngol 2018 Nov 5. Epub 2018 Nov 5.

Department of Neurology, Tianjin Union Medical Center, Tianjin 300121, China.

Background: Myasthenia gravis (MG) is an autoimmune disease. Dysarthria, dysphagia, and difficulty swallowing as exclusive initial and primary complaints in MG (laryngeal MG) are rare and seldom reported.

Methods: Here we review and analyze the largest series of laryngeal MG patients. Read More

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http://dx.doi.org/10.1016/j.amjoto.2018.11.002DOI Listing
November 2018
1 Read

Repetitive Nerve Stimulation Test in Myasthenic Crisis.

Muscle Nerve 2018 Nov 29. Epub 2018 Nov 29.

Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Introduction: We are reporting our experience with the repetitive nerve stimulation (RNS) test in myasthenia gravis (MG) crisis.

Methods: The various parameters of the RNS tests in 26 patients with MG crisis were analyzed.

Results: In 18 (69%) patients, MG crisis is the first manifestation of MG. Read More

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http://dx.doi.org/10.1002/mus.26390DOI Listing
November 2018
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Altered Gut Microbiota in Myasthenia Gravis.

Front Microbiol 2018 9;9:2627. Epub 2018 Nov 9.

Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.

Myasthenia gravis (MG) is an autoimmune-mediated disorder, the etiology of which involves both environmental factors and genetics. While the exact factors responsible for predisposition to MG remain elusive, it is hypothesized that gut microbiota play a critical role in the pathogenesis of MG. This study investigated whether gut microbiota are altered in MG patients by comparing the fecal microbiota profiles of MG patients to those of age- and sex-matched healthy controls. Read More

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http://dx.doi.org/10.3389/fmicb.2018.02627DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6241162PMC
November 2018
1 Read
3.941 Impact Factor

Diagnosis and Management of Immune Checkpoint Inhibitor-Associated Neurologic Toxicity: Illustrative Case and Review of the Literature.

Oncologist 2018 Nov 27. Epub 2018 Nov 27.

Division of Neuromuscular Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA

Immune checkpoint inhibitors (ICIs) initiate antitumor immunity by blocking the action of immune inhibitor-signaled cytotoxic proteins, such as cytotoxic T-lymphocyte-associated protein 4, programmed cell death protein 1, and programmed cell death ligand 1. However, in rare cases (∼1%-12% of patients), ICI treatment causes neurologic immune-related adverse events (irAEs). These include, but are not limited to, headache, encephalitis, neuropathies, myasthenia gravis, and myositis. Read More

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http://dx.doi.org/10.1634/theoncologist.2018-0359DOI Listing
November 2018
1 Read

Immune checkpoint inhibitors in the onset of myasthenia gravis with hyperCKemia.

Ann Clin Transl Neurol 2018 Nov 23;5(11):1421-1427. Epub 2018 Sep 23.

Department of Neurology Graduate School of Medical Sciences Faculty of Life Sciences Kumamoto University Kumamoto Japan.

Immune checkpoint inhibitors sometimes cause neuromuscular adverse events. Although a few cases of myasthenia gravis with hyperCKemia triggered by immune checkpoint inhibitors have been described, conclusive evidence remains limited. We conducted a systematic review of published cases of myasthenia gravis with hyperCKemia related to immune checkpoint inhibitors. Read More

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http://dx.doi.org/10.1002/acn3.654DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6243386PMC
November 2018
1 Read

Regulatory B cells in myasthenia gravis are differentially affected by therapies.

Ann Clin Transl Neurol 2018 Nov 22;5(11):1408-1414. Epub 2018 Sep 22.

Center of Research in Myology Sorbonne University INSERM AIM UMRS974 Paris France.

We analyzed the number and functionality of regulatory B (Breg) cells in well-defined myasthenia gravis patients. We first showed a decreased number of circulating CD19 CD24 CD38 Breg cells and an altered functionality of Breg cells in untreated myasthenia gravis patients. Next, we demonstrated that the proportion of circulating Breg cells was restored in myasthenia gravis patients after thymectomy, probably as Breg cells could be sequestered in the myasthenia gravis thymus. Read More

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http://dx.doi.org/10.1002/acn3.645DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6243377PMC
November 2018
1 Read

Autoimmune diseases associated with Neuromyelitis Optica Spectrum Disorders: A literature review.

Mult Scler Relat Disord 2018 Nov 16;27:350-363. Epub 2018 Nov 16.

MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Introduction: Neuromyelitis Optica (NMO) is an autoimmune inflammatory demyelinating disease of the central nervous system (CNS) which predominantly involves optic nerves and spinal cord. Since the introduction of Neuromyelitis Optica Spectrum Disorders (NMOSD) as a separate entity, there have been many reports on its association with other disorders including systemic and organ-specific autoimmune diseases. Here, we reviewed other immune-mediated diseases associated with NMOSD and tried to categorize them. Read More

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http://dx.doi.org/10.1016/j.msard.2018.11.008DOI Listing
November 2018
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Tacrolimus inhibits Th1 and Th17 responses in MuSK-antibody positive myasthenia gravis patients.

Exp Neurol 2018 Nov 22;312:43-50. Epub 2018 Nov 22.

Department of Surgery, Duke University Medical Center, Durham, NC, USA. Electronic address:

Muscle specific tyrosine kinase antibody positive myasthenia gravis (MuSK- MG) is characterized by autoantibodies against the MuSK protein of the neuromuscular junction resulting in weakness of bulbar and proximal muscles. We previously demonstrated that patients with MuSK-MG have increased pro-inflammatory Th1 and Th17 responses. Tacrolimus, an immunosuppressant used in AChR-MG and transplantation patients, inhibits T cell responses through interference with IL-2 transcription. Read More

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http://dx.doi.org/10.1016/j.expneurol.2018.11.006DOI Listing
November 2018
5 Reads

Neuro-Ophthalmic Disorders in Pregnancy.

Neurol Clin 2019 Feb;37(1):85-102

Department of Neurology, Brigham and Women's Hospital, 60 Fenwood Road, Boston, MA 02115, USA; Department of Ophthalmology, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA 02114, USA. Electronic address:

The physiologic changes that accompany pregnancy can have important implications for neuro-ophthalmic disease. This article discusses pregnancy-related considerations for meningioma, pituitary disorders, demyelinating disease, myasthenia gravis, thyroid eye disease, idiopathic intracranial hypertension, cerebral venous sinus thrombosis, stroke, migraine, and cranial neuropathies. The article also details the potential neuro-ophthalmic complications of preeclampsia and eclampsia and reviews the use of common diagnostic studies during pregnancy. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07338619183125
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http://dx.doi.org/10.1016/j.ncl.2018.09.001DOI Listing
February 2019
4 Reads

Management of Myasthenia Gravis in Pregnancy.

Authors:
Janet Waters

Neurol Clin 2019 Feb;37(1):113-120

Women's Neurology, University of Pittsburgh Medical Center, 3471 Fifth Avenue Suite 810, Pittsburgh, PA 15213, USA. Electronic address:

Myasthenia gravis is an autoimmune disorder characterized by fluctuating weakness of extraocular and proximal limb muscles. It occurs in 1 in 5000 in the overall population and is 2 times more common in women than men. The onset in women is most common in the third decade, and risk of severe exacerbation occurs most frequently in the year after presentation. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.09.003DOI Listing
February 2019
3 Reads

Long-term follow-up of patients with myasthenia gravis treated with low-dose rituximab.

J Neurol Neurosurg Psychiatry 2018 Nov 19. Epub 2018 Nov 19.

Department of Neurology, Princess Alexandra Hospital, Wooloongabba, Queensland, Australia

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http://dx.doi.org/10.1136/jnnp-2018-319410DOI Listing
November 2018
4 Reads

Myositis and neuromuscular side-effects induced by immune checkpoint inhibitors.

Eur J Cancer 2019 Jan 17;106:12-23. Epub 2018 Nov 17.

Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Germany. Electronic address:

Aim: To characterise clinical presentation, laboratory and histopathologic characteristics and assess the treatment and outcome of neuromuscular side-effects of checkpoint therapy.

Methods: The side-effect registry and the institutional database from ten skin cancer centres were queried for reports on myositis and neuromuscular side-effects induced by checkpoint inhibitors. In total, 38 patients treated with ipilimumab, tremelimumab, nivolumab and pembrolizumab for metastatic skin cancer were evaluated and characterised. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S09598049183140
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http://dx.doi.org/10.1016/j.ejca.2018.09.033DOI Listing
January 2019
7 Reads

Pattern of Habitual Physical Exercise in Myasthenia Gravis Patients.

J Neuromuscul Dis 2018 Nov 12. Epub 2018 Nov 12.

Background: Notwithstanding the amount of deliberate exercise, the daily patterns of active versus sedentary behavior have a major influence on health outcomes [1]. Patterns of habitual active and sedentary behavior in Myasthenia Gravis (MG) patients, as well as their possible relations to disease activity, are not known.

Objective: To evaluate baseline patterns of physical and sedentary behavior in MG patients. Read More

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http://www.medra.org/servlet/aliasResolver?alias=iospress&am
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http://dx.doi.org/10.3233/JND-180355DOI Listing
November 2018
4 Reads

Recent advances in understanding and managing myasthenia gravis.

F1000Res 2018 31;7. Epub 2018 Oct 31.

Department of Neurology, The Ohio State Wexner Medical Center, Columbus, Ohio, USA.

Autoimmune myasthenia gravis (MG) is a neuromuscular junction disorder marked clinically by fatigable muscle weakness and serologically by the presence of autoantibodies against acetylcholine receptors (AChRs), muscle-specific kinase (MuSK), or lipoprotein-related protein 4 (LPR4). Over the past few decades, the mortality of patients with MG has seen a dramatic decline secondary to evolving interventions in critical care and medical management. In the past 2 to 3 years, there have been several changes in standard of care for the treatment of MG. Read More

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https://f1000research.com/articles/7-1727/v1
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http://dx.doi.org/10.12688/f1000research.15973.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213783PMC
October 2018
7 Reads

What is in the Neuromuscular Junction Literature?

J Clin Neuromuscul Dis 2018 Dec;20(2):76-84

Pathology (Neuropathology), University of Pittsburgh School of Medicine, Pittsburgh, PA.

This update begins with myasthenia gravis and the roles of anti-agrin and cortactin antibodies. Regarding diagnosis, a report on repeated ice pack testing is highlighted as are several reports on the close correlation of electrodiagnostic testing with clinical features and the response to treatment. The incidence of head drop and associated clinical and ventilatory features are gleaned from a retrospective study. Read More

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http://dx.doi.org/10.1097/CND.0000000000000218DOI Listing
December 2018
1 Read

Satisfactory Response With Achieving Maintenance Low-Dose Prednisone in Generalized Myasthenia Gravis.

J Clin Neuromuscul Dis 2018 Dec;20(2):49-59

Neurology Department, The University of Kansas Medical Center, Kansas City, KS.

Objectives: To estimate the satisfactory response rate (SR%) with achieving maintenance, low-dose prednisone in acetylcholine receptor antibody-positive generalized myasthenia gravis.

Methods: In this retrospective study, we estimate the SR% as defined by (remission/minimal manifestations status for at least 6 months using 7.5 mg or less of prednisone daily, for maintenance treatment at 2, 4, and 6 years after symptoms onset) for patients who were not taking steroid-sparing immunosuppressant (SSI) as a primary outcome and for patients taking an SSI as a secondary outcome. Read More

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http://dx.doi.org/10.1097/CND.0000000000000219DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6241299PMC
December 2018
9 Reads

Sensitivity of MG-ADL for generalized weakness in myasthenia gravis.

Eur J Neurol 2018 Nov 12. Epub 2018 Nov 12.

Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.

Background And Purpose: Myasthenia gravis activities of daily living (MG-ADL) is a commonly used questionnaire in MG trials. To investigate whether MG-ADL is equally sensitive to oculobulbar and generalized weakness, its correlation with the oculobulbar and generalized domain of the quantitative myasthenia gravis (QMG) score was analyzed (QMGob and QMGgen, respectively). To test whether the sensitivity of MG-ADL for generalized weakness could be improved, the additional value of ACTIVLIM on top of MG-ADL in the prediction QMGgen in was investigated. Read More

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http://doi.wiley.com/10.1111/ene.13867
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http://dx.doi.org/10.1111/ene.13867DOI Listing
November 2018
7 Reads

Characterization of the thymus in Lrp4 myasthenia gravis: Four cases.

Autoimmun Rev 2018 Nov 8. Epub 2018 Nov 8.

Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands. Electronic address:

Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction. Most patients have pathogenic autoantibodies against the acetylcholine receptor (AChR). In the last years a novel subpopulation of MG patients has been described that harbors antibodies against low-density lipoprotein receptor-related protein 4 (Lrp4), another postsynaptic neuromuscular antigen. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S15689972183026
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http://dx.doi.org/10.1016/j.autrev.2018.07.011DOI Listing
November 2018
14 Reads
7.933 Impact Factor

A Natural Variant of the Signaling Molecule Vav1 Enhances Susceptibility to Myasthenia Gravis and Influences the T Cell Receptor Repertoire.

Front Immunol 2018 25;9:2399. Epub 2018 Oct 25.

Centre de Physiopathologie de Toulouse Purpan, Université de Toulouse, UPS, Inserm, CNRS, Toulouse, France.

The guanine nucleotide exchange factor Vav1 is essential for transducing T cell receptor (TCR) signals and plays an important role in T cell development and activation. Previous genetic studies identified a natural variant of Vav1 characterized by the substitution of an arginine (R) residue by a tryptophane (W) at position 63 (Vav1). This variant impacts Vav1 adaptor functions and controls susceptibility to T cell-mediated neuroinflammation. Read More

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https://www.frontiersin.org/article/10.3389/fimmu.2018.02399
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http://dx.doi.org/10.3389/fimmu.2018.02399DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6210741PMC
October 2018
10 Reads

Factors associated with quality of life of people with Myasthenia Gravis.

PLoS One 2018 8;13(11):e0206754. Epub 2018 Nov 8.

Department of Neurology, Samsung Medical Center, Sungkyunkwan University College of Medicine, Kangnam-gu, Seoul, South Korea.

Purpose: As most of patients with Myasthenia Gravis have limitations in their physical functioning, many experience changes in psychological states and often have depression. The objective of the current study was to examine the roles of communication with medical professionals, patients' loneliness, and patients' depression, in relation to their effects on the patients' quality of life.

Methods: For 120 patients with MG of 18 years and older, demographic variables, along with communication with medical professionals, loneliness, depression, and quality of life were measured. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0206754PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6226107PMC
November 2018
5 Reads

MicroRNA-143 inhibits proliferation and promotes apoptosis of thymocyte by targeting CXCL13 in myasthenia gravis mice models.

Am J Physiol Cell Physiol 2018 Nov 7. Epub 2018 Nov 7.

Key Laboratory for Biotechnology on Medicinal Plants of Jiangsu Province, School of Life Science, Jiangsu Normal University.

Myasthenia gravis (MG) is an autoimmune neuromuscular disorder, affecting the quality of life of millions of people worldwide. The current study aims to determine the relationship between microRNA-143 (miR-143) and CXCL13, and whether it influences the pathogenesis of myasthenia gravis (MG). Thymus specimens were resected from patients with thymic hyperplasia combined MG, and then infused into normal mouse cavities to establish MG mice models. Read More

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https://www.physiology.org/doi/10.1152/ajpcell.00090.2018
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http://dx.doi.org/10.1152/ajpcell.00090.2018DOI Listing
November 2018
7 Reads

Ocular myasthenia gravis patients following the administration of tacrolimus and steroids.

J Neurol Sci 2018 Oct 30;396:30-32. Epub 2018 Oct 30.

Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan.

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http://dx.doi.org/10.1016/j.jns.2018.10.027DOI Listing
October 2018
2 Reads

Unexpected dislocation following accurate total hip arthroplasty caused by excessive hip joint laxity during myasthenic crisis: a case report.

J Med Case Rep 2018 Nov 6;12(1):331. Epub 2018 Nov 6.

Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Shogoin, Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan.

Background: Dislocation following total hip arthroplasty is mainly caused by malposition. However, the coexistence of neuromuscular disorders is also considered a risk for dislocation due to excessive hip joint laxity. To minimize risk of dislocation, preoperative planning using combined anteversion has been widely used. Read More

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https://jmedicalcasereports.biomedcentral.com/articles/10.11
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http://dx.doi.org/10.1186/s13256-018-1886-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6219087PMC
November 2018
5 Reads

Assessment of oropharyngeal swallowing dysfunction in myasthenia gravis patients presenting with difficulty in swallowing.

Auris Nasus Larynx 2018 Nov 1. Epub 2018 Nov 1.

Department of Otolaryngology Head and Neck Surgery, Kumamoto University, Graduate School of Medicine, Kumamoto, Japan.

Objective: To examine the correlation between the results of a clinical neurological evaluation and swallowing dysfunction in myasthenia gravis (MG) patients who presented with difficulty in swallowing and underwent videofluorographic (VF) and fiber-optic endoscopic (FE) evaluation.

Methods: The swallowing studies of 13MG patients with difficulty in swallowing seen at the Department of Neurology from June 2016 to April 2018 were reviewed. The assessment parameters on VF and FE examination were as follows: swallowing initiation, bolus stasis at the pyriform sinus (PS) and vallecula (VC), and the degree of aspiration. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S03858146183060
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http://dx.doi.org/10.1016/j.anl.2018.10.004DOI Listing
November 2018
5 Reads

Predictive score for oral corticosteroid-induced initial worsening of seropositive generalized myasthenia gravis.

J Neurol Sci 2018 Oct 19;396:8-11. Epub 2018 Oct 19.

Department of Neurology, Graduate School of Medicine, Chiba University, Japan.

Background: Initial worsening of symptoms after the start of corticosteroid administration is a major concern in the treatment of myasthenia gravis (MG). However, the risk factors or specific patient backgrounds related to this issue have not been fully understood. We aimed to determine the risk factors and developed a scoring system for predicting initial worsening in generalized MG. Read More

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http://dx.doi.org/10.1016/j.jns.2018.10.018DOI Listing
October 2018
3 Reads

Tolerising cellular therapies: what is their promise for autoimmune disease?

Ann Rheum Dis 2018 Nov 2. Epub 2018 Nov 2.

Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK

The current management of autoimmunity involves the administration of immunosuppressive drugs coupled to symptomatic and functional interventions such as anti-inflammatory therapies and hormone replacement. Given the chronic nature of autoimmunity, however, the ideal therapeutic strategy would be to reinduce self-tolerance before significant tissue damage has accrued. Defects in, or defective regulation of, key immune cells such as regulatory T cells have been documented in several types of human autoimmunity. Read More

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http://ard.bmj.com/lookup/doi/10.1136/annrheumdis-2018-21402
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http://dx.doi.org/10.1136/annrheumdis-2018-214024DOI Listing
November 2018
10 Reads

Concentric or monopolar electrode for jitter determination in orbicularis oculi.

Clin Neurophysiol 2018 Dec 26;129(12):2552-2556. Epub 2018 Oct 26.

Institute of Physiology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Portugal; Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Portugal. Electronic address:

Objectives: To investigate if monopolar (MN) and concentric (CN) electrodes are equivalent for volitional contraction jitter estimation in orbicularis oculi (OO), and to study the effect of selecting a specific high-pass filter.

Methods: We studied neuromuscular jitter in OO on both sides in 100 consecutive patients with a clinical diagnosis of ocular myasthenia gravis (MG). We used either MN (50 patients) or CN (50 patients) electrodes in individual patients, according to a randomised protocol, with a 1kH high pass filter on one side and a 3kH filter on the other. Read More

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http://dx.doi.org/10.1016/j.clinph.2018.09.024DOI Listing
December 2018
11 Reads