The Effect of Plasmapheresis on Post-Thymectomy Ocular Dysfunction

SUMMARY:Five myasthenia gravis patients with post-thymectomy residual ocular signs were treated with plasmapheresis. Despite a significant reduction in AChR antibody titer, there was no clinical improvement. Subsequently, there was a dramatic response to prednisone. The AChR antibody titer did not correlate with the clinical state of the individual patient. It is suggested that plasmapheresis may operate by removing a thymic factor and that prednisone acts by a different mechanism.

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Neonatal Myasthenia Gravis in the Infant of an Asymptomatic Thymectomized Mother

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100043730 ◽

1982 ◽

Vol 9 (2) ◽

pp. 85-87 ◽

Cited By ~ 10

Author(s):

C. Warren Olanow ◽

Russell J.M. Lane ◽

Keith L. Hull ◽

Allen D. Roses

Keyword(s):

Myasthenia Gravis ◽

Acetylcholine Receptor ◽

Essential Role ◽

Clinical State ◽

Clinical Symptomatology ◽

Achr Antibody ◽

Antibody Titers ◽

Thymic Factor

SUMMARY:A case of neonatal myasthenia gravis is reported in the infant of an asymptomatic thymectomized mother with comparably elevated acetylcholine receptor (AChR) antibody titers. The mother remained asymptomatic despite elevated antibody titers while the infant became asymptomatic in association with the disappearance of the AChR antibody. It is suggested that the AChR antibody plays an essential role in the development of neonatal myasthenia gravis. It is also suggested that a thymic factor is necessary for the development of clinical symptomatology accounting for the lack of correlation between the clinical state of the mother and infant.

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Thymectomy is more effective than conservative treatment for myasthenia gravis regarding outcome and clinical improvement

Yearbook of Neurology and Neurosurgery ◽

10.1016/s0513-5117(09)79110-0 ◽

2009 ◽

Vol 2009 ◽

pp. 138-140 ◽

Cited By ~ 1

Author(s):

B.A. Crum

Keyword(s):

Conservative Treatment ◽

Myasthenia Gravis ◽

Clinical Improvement

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Effective Early Treatment of AChR Antibody-Positive Myasthenia Gravis with Rituximab; the Experience from a Neuroimmunology Clinic in a Developing Country

Journal of Central Nervous System Disease ◽

10.1177/11795735211016080 ◽

2021 ◽

Vol 13 ◽

pp. 117957352110160

Author(s):

Thomas Mathew ◽

Kurian Thomas ◽

Saji K John ◽

Shruthi Venkatesh ◽

Raghunandan Nadig ◽

...

Keyword(s):

Observational Study ◽

Myasthenia Gravis ◽

Treatment Option ◽

Early Treatment ◽

Early Stage ◽

Tertiary Care ◽

Response To Treatment ◽

Myasthenic Crisis ◽

Achr Antibody ◽

Significant Difference

Background: Rituximab is reserved for treating refractory myasthenia gravis (MG) patients. Here we report our experience with rituximab in AChR antibody positive generalized MG (gMG) and impending myasthenic crisis (IMC). Methods: This retrospective, observational study, conducted at a tertiary care, neuroimmunology clinic, analyzed the data of patients with AChR antibody positive gMG, treated with rituximab between 1st January 2016 and 30th October 2018. Results: Eleven patients with AChR antibody positive gMG received rituximab. Mean age of the cohort was 50.54 ± 18.71 years with 9 males. Seven out of 11 patients received rituximab in the early stage (<2 years from onset) and had good response to treatment. Four of the 5 patients with IMC improved with rituximab alone. In the 10 patients who regularly followed up, there was a significant difference between the QMG scores at baseline and at 1, 2, 6, 12, and 18 months ( P < .0001). Conclusion: Rituximab appears to be a potentially effective early treatment option for AChR antibody positive generalized MG and impending myasthenic crisis.

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Myasthenia gravis exacerbation after melatonin administration: case series from a tertiary referral centre

BMC Neurology ◽

10.1186/s12883-020-01975-y ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Velina Nedkova-Hristova ◽

Valentina Vélez-Santamaría ◽

Carlos Casasnovas

Keyword(s):

Immune System ◽

Myasthenia Gravis ◽

Clinical Improvement ◽

Case Series ◽

Adaptive Immune System ◽

Intravenous Immunoglobulins ◽

Postsynaptic Membrane ◽

Referral Centre ◽

Tertiary Referral Centre ◽

Melatonin Administration

Abstract Background Myasthenia gravis is an autoimmune disease mediated by antibodies against proteins associated with the postsynaptic membrane of the neuromuscular junction. Several drugs may trigger an exacerbation of the disease. Melatonin supplements are widely used for the treatment of insomnia as they are well tolerated with few side effects. The role of melatonin in the immune system and its effects in autoimmune disorders remain uncertain. Case presentation We identified three patients in our referral centre from 2014 to 2019 who presented a worsening within days or weeks of starting melatonin. Two of them stopped the treatment without clinical improvement in the next week. Increasing dose of corticosteroids did not lead to clinical improvement in the next month and one of the patients was finally administered intravenous immunoglobulins. Conclusion Melatonin may trigger exacerbations of myasthenia gravis, probably due to an upregulation of the adaptive immune system and an interaction with the corticosteroids and other immunosuppressant treatments. We consider that melatonin should be administered with caution in these patients.

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