Myasthenia Gravis
Myasthenia gravis
Overview:
Myasthenia Gravis is an autoimmune disorder of the post-synaptic neuromuscular junction whose pathogenesis consists in an attack on antibody-mediated At the acetylcholine receptor site on the postsynaptic membrane of the neuromuscular junction.
Causes:
Characteristics of the disease are muscle weakness and fatigue. The pattern of symptoms is typically fluctuating; it is more pronounced at night and improves with rest. Initial symptoms include: ptosis, diplopia or blurred vision in> 50% of patients; generalized weakness and fatigue in about 10%; dysphagia, weakness of facial muscles or rhinolalia in about 5%. In the elderly, usually, the most marked symptoms are borne by the extraocular muscles and bulbar. Symptoms …show more content…
The most sensitive and accurate diagnostic test is the quantitative measurement of antibodies to acetylcholine receptor. These antibodies have increased in 85-90% of patients with generalized myasthenia gravis and in 50-70% of patients with ocular myasthenia. The antibody titer also increased in> 90% of patients with thymoma.
In subjects where the test for anti-acetylcholine receptor is negative, it is useful antibody testing that modulate the receptor itself. Patients with thymoma often have increased levels of antibodies anti-striated muscle, as is observed in approximately 55% of patients> 60 years with myasthenia gravis alone. The diagnosis of thymoma uses CT or MRI; the latter provides more information about soft tissue and vascular contribution.
Treatment:
The therapy is based on drugs that increase levels of acetylcholine, such as pyridostigmine, taken orally. If this first line of treatment is not sufficient to control the symptoms, they are associated with immunosuppressive substances (corticosteroids, azathioprine) that act on the immune system by reducing the formation of autoantibodies. In the acute stages can be used sessions of plasmapheresis and gamma-globulin intravenous Sometimes, in the presence of a thymoma, it may be necessary an intervention of removal of this
Overview:
Myasthenia Gravis is an autoimmune disorder of the post-synaptic neuromuscular junction whose pathogenesis consists in an attack on antibody-mediated At the acetylcholine receptor site on the postsynaptic membrane of the neuromuscular junction.
Causes:
Characteristics of the disease are muscle weakness and fatigue. The pattern of symptoms is typically fluctuating; it is more pronounced at night and improves with rest. Initial symptoms include: ptosis, diplopia or blurred vision in> 50% of patients; generalized weakness and fatigue in about 10%; dysphagia, weakness of facial muscles or rhinolalia in about 5%. In the elderly, usually, the most marked symptoms are borne by the extraocular muscles and bulbar. Symptoms …show more content…
The most sensitive and accurate diagnostic test is the quantitative measurement of antibodies to acetylcholine receptor. These antibodies have increased in 85-90% of patients with generalized myasthenia gravis and in 50-70% of patients with ocular myasthenia. The antibody titer also increased in> 90% of patients with thymoma.
In subjects where the test for anti-acetylcholine receptor is negative, it is useful antibody testing that modulate the receptor itself. Patients with thymoma often have increased levels of antibodies anti-striated muscle, as is observed in approximately 55% of patients> 60 years with myasthenia gravis alone. The diagnosis of thymoma uses CT or MRI; the latter provides more information about soft tissue and vascular contribution.
Treatment:
The therapy is based on drugs that increase levels of acetylcholine, such as pyridostigmine, taken orally. If this first line of treatment is not sufficient to control the symptoms, they are associated with immunosuppressive substances (corticosteroids, azathioprine) that act on the immune system by reducing the formation of autoantibodies. In the acute stages can be used sessions of plasmapheresis and gamma-globulin intravenous Sometimes, in the presence of a thymoma, it may be necessary an intervention of removal of this