Articles Related to Myasthenia Gravis

Autoimmune Myasthenia gravis is a neuromuscular junction disease caused by destruction of the acetylcholine receptor on the postsynaptic membrane, mediated by autoantibodies and clinically characterized by skeletal muscle weakness. This can be triggered by drugs, infections, and in rare cases by vaccines. During the COVID pandemic, de novo cases and exacerbations of myasthenia gravis due to viral infection have been documented. Although few cases related to COVID vaccination. A 69-year-old female patient with blurred vision, a clinic that began 10 days later after receiving first dose of COVID vaccine, and diplopia and right palpebral ptosis after the second dose, 30 days later. In the examination, Edrophonium test was clearly positive, treatment with pyridostigmine and prednisone was started and after 14 days the clinic showed improvement until the resolution of the symptoms There are few reports of exacerbations or triggers for the appearance of myasthenia gravis, a series of 27 cases has been published where there are outbreaks of immune-mediated diseases or the new appearance of autoimmune diseases, in which it is observed that the time of appearance of the outbreak was on average 4 days up to a maximum of 25 days. In conclusion, Myasthenia gravis is a rare complication of the BNT162b2 COVID-19 vaccine. Its potential severity and the current lack of knowledge of the real incidence after vaccination makes it necessary to maintain an attitude of vigilance in the face of symptoms that suggest it.

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Myasthenia gravis is an autoimmune disease characterized by motor plaque dysfunction due to antibodies against post-synaptic membrane proteins. Myasthenic symptoms classically wax and wane and are more intense at the end of the day, although they may be constant in severe pictures. Almost every patient have eyelid ptosis and double vision, and the majority of them also have proximal muscle weakness. Reversible cholinesterase inhibitors are the first-line treatment, but patients who do not achieve symptom control should receive immunosuppressive therapy, whose options include azathioprine, cyclosporine, mycophenolate, intravenous immunoglobulin and thymectomy, with different profiles of efficacy, safety and tolerability.

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To remove the thymus safely and completely in the surgical management for MG, especially for the upper pole of the thymus in the neck, we have performed video-thoracoscopic extended thymectomy (VATET) with sternal elevation and carbon dioxide (CO2) insufflation. From November 2013 to May 2014, we conducted VATET for three MG patients. Symptomatic improvement was obtained, and there was neither mortality nor perioperative complications. VATET with sternal elevation and CO2 insufflation was a safe and valid technique for thymectomy for MG. Clinical short-term results were satisfactory.

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Guillain-barré syndrome (G.B. Syndrome) is an acute inflammatory poly-radiculoneuropathy characterized by weakness and areflexia typically following viral infection, vaccination, and rarely surgery. Acute Inflammatory Demyelinating Poly-radiculoneuropathy is the most common subtype of G.B. Syndrome. Although post-operative G.B. syndrome is a rare entity, there are few case reports of G.B. syndrome after gastric surgery. But there have been no reported case scenarios of atypical variety of this neurologic entity following hepato billiary surgery. Hence our objective is to put forward this message to the readers.

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