A Neurologist's Perspective on Understanding Myasthenia Gravis Clinical Perspectives of Etiologic Factors, Diagnosis, and Preoperative Treatment

被引:5
作者
Mukharesh, Loulwah [1 ]
Kaminski, Henry J. [1 ]
机构
[1] George Washington Univ, Dept Neurol, 2150 Penn Ave,NW 9th Floor, Washington, DC 20037 USA
关键词
Myasthenia gravis; Autoimmune disease; Neuromuscular junction; Thymectomy; OCULAR MYASTHENIA; DOUBLE-BLIND; MUSK; RITUXIMAB; CELLS; IMMUNOGLOBULIN; AZATHIOPRINE; THYMECTOMY; EFFICACY; UPDATE;
D O I
10.1016/j.thorsurg.2018.12.002
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Myasthenia gravis (MG) is a disease of neuromuscular transmission caused by antibodies directed toward proteins concentrated at the neuromuscular junction. Mild to life-threatening weakness varies in severity over time and with level of activity. Therefore, clinical diagnosis is often challenging. MG may be categorized by autoantibody type, thymic pathologic condition, and age of onset. Treatments are tailored for each group. A key management concern is severe exacerbation of weakness resulting from infections or exposure to certain medications, including antibiotics, which may be severe enough to produce respiratory decompensation. The article reviews key diagnostic issues and treatment options.
引用
收藏
页码:133 / +
页数:10
相关论文
共 68 条
  • [1] The role of T regulatory cells in immunopathogenesis of myasthenia gravis: implications for therapeutics
    Alahgholi-Hajibehzad, Mahdi
    Kasapoglu, Pinar
    Jafari, Reza
    Rezaei, Nima
    [J]. EXPERT REVIEW OF CLINICAL IMMUNOLOGY, 2015, 11 (07) : 859 - 870
  • [2] Regulatory function of CD4+CD25++ T cells in patients with myasthenia gravis is associated with phenotypic changes and STAT5 signaling: 1,25-Dihydroxyvitamin D3 modulates the suppressor activity
    Alahgholi-Hajibehzad, Mandi
    Oflazer, Piraye
    Aysal, Fikret
    Durmus, Hacer
    Gulsen-Parman, Yesim
    Marx, Alexander
    Deymeer, Feza
    Saruhan-Direskeneli, Guher
    [J]. JOURNAL OF NEUROIMMUNOLOGY, 2015, 281 : 51 - 60
  • [3] Pearls & Oy-sters: Pembrolizumab-induced myasthenia gravis
    Algaeed, Mohanad
    Mukharesh, Loulwah
    Heinzelmann, Morgan
    Kaminski, Henry J.
    [J]. NEUROLOGY, 2018, 91 (14) : E1365 - E1367
  • [4] Incidence and mortality rates of myasthenia gravis and myasthenic crisis in US hospitals
    Alshekhlee, A.
    Miles, J. D.
    Katirji, B.
    Preston, D. C.
    Kaminski, H. J.
    [J]. NEUROLOGY, 2009, 72 (18) : 1548 - 1554
  • [5] Autoantibodies to Low-Density Lipoprotein Receptor-Related Protein 4 in Double Seronegative Myasthenia Gravis: A Systematic Review
    Bacchi, Stephen
    Kramer, Philippe
    Chalk, Colin
    [J]. CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES, 2018, 45 (01) : 62 - 67
  • [6] Berrih-Aknin S., 2018, MYASTHENIA GRAVIS RE, P47
  • [7] Myasthenia gravis: a clinical-immunological update
    Binks, Sophie
    Vincent, Angela
    Palace, Jacqueline
    [J]. JOURNAL OF NEUROLOGY, 2016, 263 (04) : 826 - 834
  • [8] Autoreactive T Cells from Patients with Myasthenia Gravis Are Characterized by Elevated IL-17, IFN-γ, and GM-CSF and Diminished IL-10 Production
    Cao, Yonghao
    Amezquita, Robert A.
    Kleinstein, Steven H.
    Stathopoulos, Panos
    Nowak, Richard J.
    O'Connor, Kevin C.
    [J]. JOURNAL OF IMMUNOLOGY, 2016, 196 (05) : 2075 - 2084
  • [9] A systematic review of population based epidemiological studies in Myasthenia Gravis
    Carr, Aisling S.
    Cardwell, Chris R.
    McCarron, Peter O.
    McConville, John
    [J]. BMC NEUROLOGY, 2010, 10
  • [10] Anti-B cell therapy (Rituximab) in the treatment of autoimmune diseases
    Chambers, SA
    Isenberg, D
    [J]. LUPUS, 2005, 14 (03) : 210 - 214