047 Rare late onset neutropenia in a patient with multiple sclerosis treated with ocrelizumab and review of literature

Myasthenia gravis (MG) is an autoimmune condition affecting the neuromuscular junction characterised by weakness and fatiguability, carrying a high morbidity if treatment is delayed. A clear association with thymoma has led to management with thymectomy as a common practice, but MG presenting post-thymectomy has rarely been reported. We present a case of an 82- year-old woman developing fatigue, ptosis and dysarthria 3 months after thymectomy. After a clinical diagnosis of MG was made, she responded well to prompt treatment with prednisolone and pyridostigmine. Her anti-acetylcholine receptor antibody (anti-AChR) subsequently came back positive. Our systematic review reveals that post-thymectomy MG can be categorised as early-onset or late-onset form with differing aetiology, and demonstrated correlation between preoperative anti-AChR titres and post-thymectomy MG. The postulated mechanisms for post-thymectomy MG centre around long-lasting peripheral autoantibodies. Clinicians should actively look for MG symptoms in thymoma patients and measure anti-AChR preoperatively to aid prognostication.

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A case of late-onset multiple sclerosis mimicking glioblastoma and displaying intraoperative 5-aminolevulinic acid fluorescence

Acta Neurochirurgica ◽

10.1007/s00701-012-1319-z ◽

2012 ◽

Vol 154 (5) ◽

pp. 899-901 ◽

Cited By ~ 11

Author(s):

U. Nestler ◽

A. Warter ◽

P. Cabre ◽

N. Manzo

Keyword(s):

Multiple Sclerosis ◽

Aminolevulinic Acid ◽

Late Onset

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Effect of acetazolamide for long-lasting paroxysmal dystonia in a patient with multiple sclerosis: a case report and review of literature

Neuropsychiatric Disease and Treatment ◽

10.2147/ndt.s43688 ◽

2013 ◽

pp. 445

Author(s):

Yu-Ching Lin ◽

Hsieh ◽

Chen ◽

Guo ◽

Ta-Shen Kuan ◽

...

Keyword(s):

Multiple Sclerosis ◽

Case Report ◽

Review Of Literature ◽

Paroxysmal Dystonia

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The Ala/Ala genotype of PPARY Pro12 Ala polymorphism is associated with late onset of multiple sclerosis

Archives of Biological Sciences ◽

10.2298/abs1302447l ◽

2013 ◽

Vol 65 (2) ◽

pp. 447-453

Author(s):

N. Lukic ◽

A. Stankovic ◽

E. Dincic ◽

M. Bundalo ◽

Z. Krsmanovic ◽

...

Keyword(s):

Multiple Sclerosis ◽

Late Onset ◽

Age At Onset ◽

Peroxisome Proliferator ◽

Pro12ala Polymorphism ◽

Peroxisome Proliferator Activated Receptor ◽

Post Hoc ◽

Genotype And Allele Frequencies

The function of peroxisome proliferator-activated receptor ? (PPAR?) in immune regulation, as well as in antiinflammatory and anti-proliferative actions towards T lymphocytes, has been reported. A potential role of PPARs in multiple sclerosis (MS) was suggested. The aim of this study was to investigate if there is an association of PPAR?-2 Pro12Ala polymorphism with MS in 361 patients from Serbia. The genotype and allele frequencies of Pro12Ala polymorphism were not significantly different between controls and patients, or between females and males. In contrast to controls, we detected a rare Ala/Ala genotype in patients with MS. We found that there is a significant association of Ala/Ala genotype with older age at onset (ANOVA, p=0.07; LSD post-hoc, Ala/Ala vs. Pro/Ala, p=0.03, Ala/Ala vs. Pro/Pro p=0.02). It would be useful to validate our results in other populations, as well as to perform follow-up of the disease progression in regard to PPAR? genotypes.

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Hope-based interventions in chronic disease: an integrative review in the light of Nightingale

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2020-0283 ◽

2020 ◽

Vol 73 (suppl 5) ◽

Author(s):

Carlos António Laranjeira ◽

Ana Isabel Fernandes Querido ◽

Zaida Borges Charepe ◽

Maria dos Anjos Coelho Rodrigues Dixe

Keyword(s):

Multiple Sclerosis ◽

Scientific Literature ◽

Thought Process ◽

Review Of Literature ◽

Inclusion Criteria ◽

Clinical Practices ◽

Spiritual Transcendence ◽

Florence Nightingale ◽

Rational Thought ◽

Experiential Process

ABSTRACT Objective: To identify the available evidence in the scientific literature about the strategies or interventions used to promote hope in people with chronic diseases. Method: An integrative literature review of literature published between 2009-2019, which was conducted in online browsers/databases: b-On, EBSCO, PubMed, Medline, ISI, SciELO, PsycINFO, Google Scholar. Forty-one studies were found, of which eight met the inclusion criteria. Results: Most studies used a quantitative approach. There was a predominance of studies from Asia and America, addressing patients with multiple sclerosis, diabetes, congestive heart failure, and cancer. Hope-based interventions were categorized by the hope attributes: experiential process, spiritual/transcendence process, rational thought process, and relational process. Conclusion: Hope-based interventions, in its essence, are good clinical practices in the physical, psychological, social and spiritual domains. This is congruent with the vision of nursing, first proposed by Florence Nightingale. There seem to be gaps in the literature regarding specific hope promoting interventions.

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