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https://www.readbyqxmd.com/read/28921038/efficacy-and-safety-of-tacrolimus-for-myasthenia-gravis-a-systematic-review-and-meta-analysis
#1
REVIEW
Liang Wang, Suxian Zhang, Jianying Xi, Wenhui Li, Lei Zhou, Jun Lu, Jiahong Lu, Tiansong Zhang, Chongbo Zhao
To evaluate the efficacy and safety of tacrolimus in patients with myasthenia gravis (MG), a systematic review and meta-analysis was performed. We searched PubMed and Embase for randomized controlled trials and clinical controlled trials in English language. Demographic and clinical characteristics of the MG patients were extracted. Differences in the current glucocorticoids (GC) dose in each included study were the primary outcome measure. The adverse events reported in each included study were used as safety evaluation...
September 18, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28919008/immunoadsorption-in-neurological-disorders
#2
REVIEW
Satoru Oji, Kyoichi Nomura
In recent years, immunoadsorption has been increasingly recognized as an alternative to therapeutic plasma exchange and used for the treatment of neurological disorders such as Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, myasthenia gravis, neuromyelitis optica spectrum disorders, and multiple sclerosis, as well as autoimmune encephalitis. Unlike therapeutic plasma exchange, which requires fluid replacement with a blood solution such as fresh frozen plasma or albumin, immunoadsorption is a blood purification technique that enables the selective removal of humoral factors from separated plasma through a high-affinity adsorbent with tryptophan or phenylalanine...
August 26, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28916122/myasthenia-gravis-and-crisis-evaluation-and-management-in-the-emergency-department
#3
Jamie Roper, M Emily Fleming, Brit Long, Alex Koyfman
BACKGROUND: Myasthenia gravis (MG) is an uncommon autoimmune disorder affecting the neuromuscular junction and manifesting as muscle weakness. A multitude of stressors can exacerbate MG. When symptoms are exacerbated, muscle weakness can be severe enough to result in respiratory failure, a condition known as myasthenic crisis (MC). OBJECTIVE: This review discusses risk factors, diagnosis, management, and iatrogenic avoidance of MC. DISCUSSION: MC can affect any age, ethnicity, or sex and can be precipitated with any stressor, infection being the most common...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28914199/clinical-applications-of-intravenous-immunoglobulins-in-child-neurology
#4
Maria Gogou, Efimia Papadopoulou-Alataki, Martha Spilioti, Sofia Alataki, Athanasios Evangeliou
BACKGROUND: While there are guidelines for the use of intravenous immunoglobulins in children with Guillain-Barre syndrome and myasthenia gravis based on high-level evidence studies, data is fewer for the majority of neurologic disorders in this age group. Neuronal antibodies are detected in children with seizures of autoimmune etiology. Intravenous immunoglobulins with their broad immunomodulatory mechanism of action could be ideally effective in different forms of immune-dysregulated intractable epilepsies such as autoimmune epilepsy and autoimmune Rasmussen encephalitis...
September 15, 2017: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/28912035/specific-removal-of-autoantibodies-by-extracorporeal-immunoadsorption-ameliorates-experimental-autoimmune-myasthenia-gravis
#5
Konstantinos Lazaridis, Ioannis Dalianoudis, Vasiliki Baltatzidi, Socrates J Tzartos
Myasthenia gravis (MG) is caused by autoantibodies, the majority of which target the muscle acetylcholine receptor (AChR). Plasmapheresis and IgG-immunoadsorption are useful therapy options, but are highly non-specific. Antigen-specific immunoadsorption would remove only the pathogenic autoantibodies, reducing the possibility of side effects while maximizing the benefit. We have extensively characterized such adsorbents, but in vivo studies are missing. We used rats with experimental autoimmune MG to perform antigen-specific immunoadsorptions over three weeks, regularly monitoring symptoms and autoantibody titers...
September 6, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28893803/pure-red-cell-aplasia-and-myasthenia-gravis-a-patient-having-both-autoimmune-conditions-in-the-absence-of-thymoma
#6
Annelise Aquilina, David James Camilleri, Josanne Aquilina
This is a patient who was presented initially with symptoms of malaise, tiredness and exertional dyspnoea and found to have a severe normocytic normochromic anaemia with low reticulocyte counts. Bone marrow confirmed the diagnosis of pure red cell aplasia (PRCA) and at the time serology for recent parvovirus infection was positive. He was successfully treated with transfusions and intravenous Ig. Six years later, he had a mild relapse of his PRCA and subsequently developed severe dysphagia and dysarthria which were fatigable...
September 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28890897/corrigendum-to-detecting-key-genes-regulated-by-mirnas-in-dysfunctional-crosstalk-pathway-of-myasthenia-gravis
#7
Yuze Cao, Jianjian Wang, Huixue Zhang, Qinghua Tian, Lixia Chen, Shangwei Ning, Peifang Liu, Xuesong Sun, Xiaoyu Lu, Chang Song, Shuai Zhang, Bo Xiao, Lihua Wang
[This corrects the article DOI: 10.1155/2015/724715.].
2017: BioMed Research International
https://www.readbyqxmd.com/read/28890037/the-association-between-scabies-and-myasthenia-gravis-a-nationwide-population-based-cohort-study
#8
Ren-Jun Hsu, Chien-Yu Lin, Fung-Wei Chang, Chun-Fa Huang, Heng-Chang Chuang, Jui-Ming Liu
Scabies is an infectious inflammatory pruritic skin disease. Cytokine-mediated inflammatory processes contribute to the pathologic mechanism in scabies. Myasthenia gravis (MG) is also an autoimmune disease that is mediated by cytokines. The study aimed to investigate the association between scabies and myasthenia gravis. We conducted a nationwide population-based cohort study utilized data from the National Health Insurance Research Database (NHIRD) of Taiwan. Patients with scabies (n=5429) and control subjects without scabies (n=20,176) were enrolled...
September 7, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28889846/acupuncture-for-management-of-type-2-diabetes-mellitus-in-a-patient-with-myasthenia-gravis-a-case-report
#9
Yun Jin Kim
Myasthenia gravis (MG) is an acquired disease of the neuromuscular junctions characterized by muscular weakness and fatigue, with a prevalence of 50-125 cases per million population in western countries. In men, it usually appears after the age of 60 years, while in women, it usually appears before the age of 40 years. Long-term immunosuppression with corticosteroids is the mainstay treatment for patients with MG; however, the use of corticosteroids is a well-documented risk factor for type 2 diabetes mellitus, which has also been reported in steroid-treated patients with MG...
August 2017: Journal of Acupuncture and Meridian Studies
https://www.readbyqxmd.com/read/28885698/autoimmune-antibodies-to-collagen-xiii-in-myasthenia-gravis-patients
#10
Hongmin Tu, Ritva Pirskanen-Matell, Anne Heikkinen, Tuomo Oikarainen, Juha Risteli, Taina Pihlajaniemi
INTRODUCTION: Myasthenia Gravis (MG) is a neuromuscular junction (NMJ) disorder caused by autoantibodies against NMJ proteins. Collagen XIII is a muscle-derived transmembrane protein required for NMJ maturation. The objective of this study is to explore existence of autoantibodies to collagen XIII in MG patients. METHODS: Seventy MG patient sera and 61 human healthy controls were screened for collagen XIII autoantibodies by enzyme-linked immunosorbent assay (ELISA)...
September 8, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28884124/response-to-comment-on-detecting-key-genes-regulated-by-mirnas-in-dysfunctional-crosstalk-pathway-of-myasthenia-gravis
#11
COMMENT
Yuze Cao, Jianjian Wang, Huixue Zhang, Qinghua Tian, Lixia Chen, Shangwei Ning, Peifang Liu, Xuesong Sun, Xiaoyu Lu, Chang Song, Shuai Zhang, Bo Xiao, Lihua Wang
No abstract text is available yet for this article.
2017: BioMed Research International
https://www.readbyqxmd.com/read/28882932/hickam-s-dictum-myasthenia-gravis-presenting-concurrently-with-graves-disease
#12
Shekhar Sehgal, Roshan Rebello, Louise Wolmarans, Marianne Elston
We present two patients with Graves' disease and concurrent myasthenia gravis. The impact of the dual diagnosis on the clinical course and the potential for a delayed diagnosis of myasthenia gravis is discussed. Patient 1, a 28-year-old man was diagnosed with Graves' disease following his second respiratory arrest. His history was strongly suggestive of a second pathology. Patient 2, a 66-year-old Cantonese woman with established Graves' disease presented with thionamide-related neutropaenia. Examination revealed bilateral ptosis and right lateral rectus palsy...
September 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28881516/-effectiveness-and-safety-of-rituximab-for-children-with-autoimmune-diseases-of-the-nervous-system
#13
Z Fu, X H Bao, Y Wu, J Zhou, Y H Zhang, Y Zhang, T Y Ji, Y Chen
Objective: To assess the effectiveness and safety of rituximab in Chinese children with autoimmune diseases of the nervous system. Method: An ambispective cohort study enrolled patients with refractory and(or) relapse autoimmune diseases of nervous system from June 2010 to June 2016 in Peking University First Hospital.These patients failed to respond to steroids and(or)intravenous immunoglobulin (IVIG) were treated with rituximab and seen for follow-up visits once every 3 months.The effectiveness was assessed by modified Rankin scale (mRs) and the annualized relapse rate...
September 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28881457/ocular-presentation-of-myasthenia-gravis-a-natural-history-cohort
#14
Sivesh K Kamarajah, Girija Sadalage, Jonathan Palmer, Helena Carley, Paul Maddison, Arulmaran Sivaguru
INTRODUCTION: There is limited data on the natural history of untreated myasthenia gravis (MG) with ocular presentation. METHODS: We analysed 93 patients from symptom onset presenting to Birmingham Midlands Eye Centre (BMEC) from January 2004 to July 2015. We used multiple stepwise logistic regression to identify predictive factors of generalisation and Kaplan-Meier analysis on time to generalisation. RESULTS: 46% of patients developed generalised symptoms during the study period...
September 7, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28878127/autoantibody-producing-plasmablasts-after-b-cell-depletion-identified-in-muscle-specific-kinase-myasthenia-gravis
#15
Panos Stathopoulos, Aditya Kumar, Richard J Nowak, Kevin C O'Connor
Myasthenia gravis (MG) is a B cell-mediated autoimmune disorder of neuromuscular transmission. Pathogenic autoantibodies to muscle-specific tyrosine kinase (MuSK) can be found in patients with MG who do not have detectable antibodies to the acetylcholine receptor (AChR). MuSK MG includes immunological and clinical features that are generally distinct from AChR MG, particularly regarding responsiveness to therapy. B cell depletion has been shown to affect a decline in serum autoantibodies and to induce sustained clinical improvement in the majority of MuSK MG patients...
September 7, 2017: JCI Insight
https://www.readbyqxmd.com/read/28877546/clinical-features-and-evolution-of-juvenile-myasthenia-gravis-in-a-french-cohort
#16
Coline Barraud, Isabelle Desguerre, Christine Barnerias, Cyril Gitiaux, Christophe Boulay, Brigitte Chabrol
OBJECTIVE: We determined the clinical, paraclinical, and treatment-related features of juvenile myasthenia gravis (JMG) as well as the clinical course in a cohort of French children. METHODS: We conducted a retrospective study of 40 patients with JMG at 2 French Pediatric Neurology departments from April 2004 to April 2014. RESULTS: Among the patients, 70% had generalized JMG, 52% had positive acetylcholine receptor antibodies, 8% had muscle-specific-kinase antibodies, and 40% were seronegative...
September 6, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28875521/chronic-myocarditis-with-a-long-clinical-course-report-of-an-autopsy-case-of-probable-autoimmune-myocarditis
#17
Masayuki Shintaku, Koji Uchiyama, Yohei Kobayashi
The patient was a 54-year-old woman, who died of chronic cardiac insufficiency after a clinical course of 2 years and 4 months. She had complained of myalgia, muscle weakness, and blepharoptosis before the onset of cardiac symptoms, but there was no evidence of myasthenia gravis or collagen-vascular diseases. At autopsy, the heart (280 g) showed marked dilatation of the four chambers and thinning of the ventricular walls. Diffuse and intense lymphocytic infiltration and extensive fibrosis were noted, with the latter being accentuated in the subendocardial and subepicardial zones...
September 6, 2017: Pathology International
https://www.readbyqxmd.com/read/28874083/azathioprine-induced-pancytopenia-and-septic-complications-a-probable-cause-of-death
#18
Bijoy K Panda, Siddhi Umarje, Arundhati Diwan
Azathioprine, an immunosuppressant which is widely used in the management of the autoimmune neuromuscular disorder. Myasthenia gravis is known to cause myelotoxicity. A 55-year-old male recently diagnosed with myasthenia gravis and chronic kidney disease was put on azathioprine (100 mg/d) along with pyridostigmine and prednisolone. When the treatment was initiated, the hematological reports revealed normal levels of blood count. However, approximately within 3 weeks of continuing the prescribed drugs, the patient was readmitted for complaints of loose watery stools, weakness, and giddiness...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28872522/diagnostic-utility-of-repetitive-nerve-stimulation-in-a-large-cohort-of-patients-with-myasthenia-gravis
#19
Åsa Amandusson, Kristin Elf, Margareta E Grindlund, Anna R Punga
PURPOSE: Optimizing the diagnostic utility of repetitive nerve stimulation in myasthenia gravis (MG) may include tailoring the examination to clinical phenotype. Therefore, we analyzed all available repetitive nerve stimulation parameters in a large cohort of patients with confirmed MG diagnosis. METHODS: All repetitive nerve stimulation examinations at the Uppsala University Hospital rendering an MG diagnosis during 1996 to 2014 were analyzed. The deltoid, trapezius, anconeus, nasalis, abductor digiti quinti, and frontalis muscles were examined...
September 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28869483/obinutuzumab-plus-chlorambucil-in-a-patient-with-severe-myasthenia-gravis-and-chronic-lymphocytic-leukemia
#20
Angela Russell, Megan Yaraskavitch, Daniel Fok, Sameer Chhibber, Lesley Street, Lawrence Korngut
Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction, characterized by fatigable weakness of the extraocular, bulbar, and limb musculature; prevalence is estimated at 14 to 32 per 100,000 in North America. Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in adults, resulting from clonal expansion of B-cells in blood, marrow, and secondary lymphoid tissues. The simultaneous presentation of MG and CLL is exceedingly rare. This article presents the case of 71-year-old man diagnosed simultaneously with MG and CLL...
2017: Journal of Neuromuscular Diseases
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