KATHERIN CARRILLO

FUNDACION UNIVERSITARIA DE CIENCIA DE LA SALUD

III SEMESTRE DE ENFERMERIA INFORMATICA

La miastenia gravis (MG) es una enfermedad autoinmune que se caracteriza por la presencia de debilidad muscular fluctuante y fatiga de distintos grupos musculares Los responsables del fallo en la transmisioacuten sinaacuteptica que producen las manifestaciones cliacutenicas son los anticuerpos dirigidos contra los receptores nicotiacutenicos de acetilcolina de la membrana post sinaacuteptica en la unioacuten neuromuscular

Cansancio agudo falta de fuerza muscular La caiacuteda de uno o ambos paacuterpados (ptosis) Visioacuten nublada o doble (diplopiacutea) a consecuencia de la debilidad

de los muacutesculos que controlan los movimientos oculares Marcha inestable o irregular debilidad en los brazos las manos

los dedos las piernas y el cuello Dificultad para subir escaleras Cambio en la expresioacuten facial dificultad para sonreiacuter y

gesticular Dificultad para deglutir alimentos (soacutelidos ya sea por la falta de

fuerza para masticar y liacutequidos como el agua por ejemplo en consecuencia a la falta de fuerza para tragar)

Dificultad para respirar Trastornos en el habla (disartria) La voz sale como gangosa en

consecuencia de la falta de fuerza en las cuerdas vocales la lengua

Prueba farmacoloacutegica La primera prueba diagnoacutestica se realiza generalmente con el cloruro de edrofonio (prueba de Tensilon) endovenoso La dosis inicial es de 1mg seguida de 23 y 5 mg en intervalos de 3 a 5 minutos Se debe disponer de una jeringa con atropina para controlar los siacutentomas gastrointestinales o en casos raros de bradicardia e hipotensioacuten

Pruebas electrofisioloacutegicas La estimulacioacuten repetitiva de distintos nervios es el meacutetodo electrofisioloacutegico maacutes frecuentemente utilizado para detectar una alteracioacuten de la transmisioacuten neuromuscular La temperatura del miembro que se va a estudiar debe ser mayor de 34degC y el paciente debe abstenerse de tomar inhibidores de la colinsterasa 12 horas antes del estudio

Anticuerpos contra receptores de acetilcolina La presencia de ACRA en pacientes con manifestaciones cliacutenicas compatibles o caracteriacutesticas de la MG confirma el diagnoacutestico Existen tres tipos de anticuerpos bloqueantes moduladores y de ligadura

Estudios radioloacutegicos Un 10 de los pacientes de MG padecen timomas La mayoriacutea de estos tumores son benignos pero son localmente invasores Por esta razoacuten se recomienda obtener una tomografiacutea computarizada o una resonancia magneacutetica de torax en todo paciente diagnosticado con MG

Faacutermacos anticolinesteraacutesicos Este grupo de sustancia prolonga la accioacuten de la acetilcolina en la unioacuten neuromuscular y mejora la debilidad muscular en cierto grupo de pacientes con MG El bromuro de piridostigmina (Mestinon) se utiliza frecuentemente en dosis de 30-60mg cada 3 a 6 horas

Corticosteroides Muchos pacientes mejoran con la administracioacuten de corticosteroides La predisponga en dosis de 1mg kgdiacutea resulta eficaz en la mejoriacutea de la debilidad muscular

Plasmafeacuteresis La PF es uacutetil y eficaz en pacientes con compromiso respiratorio o bulbar que ponen en riesgo la vida del paciente Tambieacuten se utiliza para preparar al paciente previo a la timectomiacutea y acelerar la recuperacioacuten en casos de crisis miasteacutenicas

Inmunoglobulina Recientemente se ha utilizado inmunoglobulina endovenosa (Igev) en grandes dosis con buenos resultados en pacientes con MG La dosis administrada es de 04 gkgdiacutea durante cinco diacuteas consecutivos y los beneficios son transitorios

Inmunosupresores La azatioprina es efectiva en dosis de 2-3 mgkgdiacutea Se puede realizar sola o combinada con los corticosteroides

Timectomiacutea La timectomiacutea es maacutes eficaz en adultos joacutevenes (lt40 antildeos) con MG generalizada pero tambieacuten se benefician de ella otros pacientes En pacientes con MGO los beneficios de la timectomiacutea no son tan obvios y existe una demora de seis meses a varios antildeos en la observacioacuten de los beneficios de eacutesta

Abstract Myasthenia gravis is often difficult to diagnose and treat in older

subjects due to complications previous history and reciprocal interaction with drugs used to treat complications An 84-year-old woman with slowly progressive 2-year dysphagia and dysarthria had reached critical condition with aspiration pneumonia She was diagnosed with thymoma-free myasthenia gravis and her respirator removed after being administrated an anticholinesterase drug Her dysphagia and dysarthria did not improve Because of severe osteoporosis with two previous lumbar compression fractures and excessive thinness she could not be given prednisolone or immunosuppressive drugs Following cricopharyngeal myotomy and bilateral lateral palatopharyngeal wall narrowing she could eat without misdeglutition and speak clearly

El articulo nos habla que es mas difiacutecil de tratar y diagnosticar a persona de edad mayor porque puede tener complicaciones Nos habla de una mujer de 84 antildeos que tenia disfasia por 2 antildeos y con neumoniacutea por aspiracioacuten y le descubrieron miastenia gravis Fue mucho mas difiacutecil el tratamiento de su enfermedad y la edad

Abstract

Antititin antibody occurs in the serum of myasthenia gravis (MG) patients with thymoma (MGT) and is a diagnostic marker for the disease The mechanism that triggers MGT development is however unclear This study evaluated the role of the main immunogenic region (MIR) of titin in MGT pathogenesis Titin MIR antiserum (antibody titre 116) was obtained and an in situ immunohistochemical study of thymomatous tissue samples was performed Strong immunostaining for titin MIR was observed on epithelial cell membranes in MGT patients and the degree of immunostaining was directly proportional to the number of epithelial cells in thymomatous tissue Serum antititin antibody levels were closely related to titin MIR levels in thymoma cells however titin MIR levels did not appear to be related to MG severity Antititin antibody may be a good surrogate marker for thymoma but is probably not involved in the pathogenesis of MGT

El articulo nos habla Anticuerpos Antititin se produce en el suero de la miasteniaGravis es un marcador para diagnosticar las enfermedades sin embargo no esta Claro pero este estudio evaluoacute el papel de la principal regioacuten inmunogeacutenica Losniveles seacutericos de anticuerpos antititin estaban estrechamente relacionados con los niveles de titina MIR en las ceacutelulas de timoma

Abstract

Dysphagia as the sole manifestation of myasthenia gravis is very rare Here we describe a case of an adult patient who developed an insidious onset of oropharyngeal dysphagia as the first and sole manifestation of myasthenia gravis After multiple evaluations the underlying disease was recognized by electromyographics studies English and Spanish literature on the matter was reviewed

El articulo nos describe el caso de un paciente adulto que desarrolloacute un inicio insidioso de la disfagia orofariacutengea como la manifestacioacuten primera y uacutenica de la miastenia gravis Despueacutes de las evaluaciones muacuteltiples de la enfermedad subyacente fue reconocido por los estudios electromiografiacutea

Abstract We report two female patients with neuromyelitis optica (NMO Devics

syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgWe report two female patients with neuromyelitis optica (NMO Devics syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgG autoantibody against aquaporin-4 water channel was absent from their sera Both NMO and MG are relatively rare diseases The considerable coincidence of these two disorders suggests that there is a subgroup of patients with NMO having a common immunological pathogenesis with MG

El articulo nos habla sobre dos mujeres la cual presentan neuromielitis optica que hace referencia con la miastenia gravis estas enfermedades se caracterizan por mielitis subaguda con neuritis oacuteptica los altos niveles seacutericos de anticuerpos del receptor de acetilcolina del muacutesculo y la enfermedad tiroidea autoinmune

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

La miastenia gravis (MG) es una enfermedad autoinmune que se caracteriza por la presencia de debilidad muscular fluctuante y fatiga de distintos grupos musculares Los responsables del fallo en la transmisioacuten sinaacuteptica que producen las manifestaciones cliacutenicas son los anticuerpos dirigidos contra los receptores nicotiacutenicos de acetilcolina de la membrana post sinaacuteptica en la unioacuten neuromuscular

Cansancio agudo falta de fuerza muscular La caiacuteda de uno o ambos paacuterpados (ptosis) Visioacuten nublada o doble (diplopiacutea) a consecuencia de la debilidad

de los muacutesculos que controlan los movimientos oculares Marcha inestable o irregular debilidad en los brazos las manos

los dedos las piernas y el cuello Dificultad para subir escaleras Cambio en la expresioacuten facial dificultad para sonreiacuter y

gesticular Dificultad para deglutir alimentos (soacutelidos ya sea por la falta de

fuerza para masticar y liacutequidos como el agua por ejemplo en consecuencia a la falta de fuerza para tragar)

Dificultad para respirar Trastornos en el habla (disartria) La voz sale como gangosa en

consecuencia de la falta de fuerza en las cuerdas vocales la lengua

Prueba farmacoloacutegica La primera prueba diagnoacutestica se realiza generalmente con el cloruro de edrofonio (prueba de Tensilon) endovenoso La dosis inicial es de 1mg seguida de 23 y 5 mg en intervalos de 3 a 5 minutos Se debe disponer de una jeringa con atropina para controlar los siacutentomas gastrointestinales o en casos raros de bradicardia e hipotensioacuten

Pruebas electrofisioloacutegicas La estimulacioacuten repetitiva de distintos nervios es el meacutetodo electrofisioloacutegico maacutes frecuentemente utilizado para detectar una alteracioacuten de la transmisioacuten neuromuscular La temperatura del miembro que se va a estudiar debe ser mayor de 34degC y el paciente debe abstenerse de tomar inhibidores de la colinsterasa 12 horas antes del estudio

Anticuerpos contra receptores de acetilcolina La presencia de ACRA en pacientes con manifestaciones cliacutenicas compatibles o caracteriacutesticas de la MG confirma el diagnoacutestico Existen tres tipos de anticuerpos bloqueantes moduladores y de ligadura

Estudios radioloacutegicos Un 10 de los pacientes de MG padecen timomas La mayoriacutea de estos tumores son benignos pero son localmente invasores Por esta razoacuten se recomienda obtener una tomografiacutea computarizada o una resonancia magneacutetica de torax en todo paciente diagnosticado con MG

Faacutermacos anticolinesteraacutesicos Este grupo de sustancia prolonga la accioacuten de la acetilcolina en la unioacuten neuromuscular y mejora la debilidad muscular en cierto grupo de pacientes con MG El bromuro de piridostigmina (Mestinon) se utiliza frecuentemente en dosis de 30-60mg cada 3 a 6 horas

Corticosteroides Muchos pacientes mejoran con la administracioacuten de corticosteroides La predisponga en dosis de 1mg kgdiacutea resulta eficaz en la mejoriacutea de la debilidad muscular

Plasmafeacuteresis La PF es uacutetil y eficaz en pacientes con compromiso respiratorio o bulbar que ponen en riesgo la vida del paciente Tambieacuten se utiliza para preparar al paciente previo a la timectomiacutea y acelerar la recuperacioacuten en casos de crisis miasteacutenicas

Inmunoglobulina Recientemente se ha utilizado inmunoglobulina endovenosa (Igev) en grandes dosis con buenos resultados en pacientes con MG La dosis administrada es de 04 gkgdiacutea durante cinco diacuteas consecutivos y los beneficios son transitorios

Inmunosupresores La azatioprina es efectiva en dosis de 2-3 mgkgdiacutea Se puede realizar sola o combinada con los corticosteroides

Timectomiacutea La timectomiacutea es maacutes eficaz en adultos joacutevenes (lt40 antildeos) con MG generalizada pero tambieacuten se benefician de ella otros pacientes En pacientes con MGO los beneficios de la timectomiacutea no son tan obvios y existe una demora de seis meses a varios antildeos en la observacioacuten de los beneficios de eacutesta

Abstract Myasthenia gravis is often difficult to diagnose and treat in older

subjects due to complications previous history and reciprocal interaction with drugs used to treat complications An 84-year-old woman with slowly progressive 2-year dysphagia and dysarthria had reached critical condition with aspiration pneumonia She was diagnosed with thymoma-free myasthenia gravis and her respirator removed after being administrated an anticholinesterase drug Her dysphagia and dysarthria did not improve Because of severe osteoporosis with two previous lumbar compression fractures and excessive thinness she could not be given prednisolone or immunosuppressive drugs Following cricopharyngeal myotomy and bilateral lateral palatopharyngeal wall narrowing she could eat without misdeglutition and speak clearly

El articulo nos habla que es mas difiacutecil de tratar y diagnosticar a persona de edad mayor porque puede tener complicaciones Nos habla de una mujer de 84 antildeos que tenia disfasia por 2 antildeos y con neumoniacutea por aspiracioacuten y le descubrieron miastenia gravis Fue mucho mas difiacutecil el tratamiento de su enfermedad y la edad

Abstract

Antititin antibody occurs in the serum of myasthenia gravis (MG) patients with thymoma (MGT) and is a diagnostic marker for the disease The mechanism that triggers MGT development is however unclear This study evaluated the role of the main immunogenic region (MIR) of titin in MGT pathogenesis Titin MIR antiserum (antibody titre 116) was obtained and an in situ immunohistochemical study of thymomatous tissue samples was performed Strong immunostaining for titin MIR was observed on epithelial cell membranes in MGT patients and the degree of immunostaining was directly proportional to the number of epithelial cells in thymomatous tissue Serum antititin antibody levels were closely related to titin MIR levels in thymoma cells however titin MIR levels did not appear to be related to MG severity Antititin antibody may be a good surrogate marker for thymoma but is probably not involved in the pathogenesis of MGT

El articulo nos habla Anticuerpos Antititin se produce en el suero de la miasteniaGravis es un marcador para diagnosticar las enfermedades sin embargo no esta Claro pero este estudio evaluoacute el papel de la principal regioacuten inmunogeacutenica Losniveles seacutericos de anticuerpos antititin estaban estrechamente relacionados con los niveles de titina MIR en las ceacutelulas de timoma

Abstract

Dysphagia as the sole manifestation of myasthenia gravis is very rare Here we describe a case of an adult patient who developed an insidious onset of oropharyngeal dysphagia as the first and sole manifestation of myasthenia gravis After multiple evaluations the underlying disease was recognized by electromyographics studies English and Spanish literature on the matter was reviewed

El articulo nos describe el caso de un paciente adulto que desarrolloacute un inicio insidioso de la disfagia orofariacutengea como la manifestacioacuten primera y uacutenica de la miastenia gravis Despueacutes de las evaluaciones muacuteltiples de la enfermedad subyacente fue reconocido por los estudios electromiografiacutea

Abstract We report two female patients with neuromyelitis optica (NMO Devics

syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgWe report two female patients with neuromyelitis optica (NMO Devics syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgG autoantibody against aquaporin-4 water channel was absent from their sera Both NMO and MG are relatively rare diseases The considerable coincidence of these two disorders suggests that there is a subgroup of patients with NMO having a common immunological pathogenesis with MG

El articulo nos habla sobre dos mujeres la cual presentan neuromielitis optica que hace referencia con la miastenia gravis estas enfermedades se caracterizan por mielitis subaguda con neuritis oacuteptica los altos niveles seacutericos de anticuerpos del receptor de acetilcolina del muacutesculo y la enfermedad tiroidea autoinmune

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

Cansancio agudo falta de fuerza muscular La caiacuteda de uno o ambos paacuterpados (ptosis) Visioacuten nublada o doble (diplopiacutea) a consecuencia de la debilidad

de los muacutesculos que controlan los movimientos oculares Marcha inestable o irregular debilidad en los brazos las manos

los dedos las piernas y el cuello Dificultad para subir escaleras Cambio en la expresioacuten facial dificultad para sonreiacuter y

gesticular Dificultad para deglutir alimentos (soacutelidos ya sea por la falta de

fuerza para masticar y liacutequidos como el agua por ejemplo en consecuencia a la falta de fuerza para tragar)

Dificultad para respirar Trastornos en el habla (disartria) La voz sale como gangosa en

consecuencia de la falta de fuerza en las cuerdas vocales la lengua

Prueba farmacoloacutegica La primera prueba diagnoacutestica se realiza generalmente con el cloruro de edrofonio (prueba de Tensilon) endovenoso La dosis inicial es de 1mg seguida de 23 y 5 mg en intervalos de 3 a 5 minutos Se debe disponer de una jeringa con atropina para controlar los siacutentomas gastrointestinales o en casos raros de bradicardia e hipotensioacuten

Pruebas electrofisioloacutegicas La estimulacioacuten repetitiva de distintos nervios es el meacutetodo electrofisioloacutegico maacutes frecuentemente utilizado para detectar una alteracioacuten de la transmisioacuten neuromuscular La temperatura del miembro que se va a estudiar debe ser mayor de 34degC y el paciente debe abstenerse de tomar inhibidores de la colinsterasa 12 horas antes del estudio

Anticuerpos contra receptores de acetilcolina La presencia de ACRA en pacientes con manifestaciones cliacutenicas compatibles o caracteriacutesticas de la MG confirma el diagnoacutestico Existen tres tipos de anticuerpos bloqueantes moduladores y de ligadura

Estudios radioloacutegicos Un 10 de los pacientes de MG padecen timomas La mayoriacutea de estos tumores son benignos pero son localmente invasores Por esta razoacuten se recomienda obtener una tomografiacutea computarizada o una resonancia magneacutetica de torax en todo paciente diagnosticado con MG

Faacutermacos anticolinesteraacutesicos Este grupo de sustancia prolonga la accioacuten de la acetilcolina en la unioacuten neuromuscular y mejora la debilidad muscular en cierto grupo de pacientes con MG El bromuro de piridostigmina (Mestinon) se utiliza frecuentemente en dosis de 30-60mg cada 3 a 6 horas

Corticosteroides Muchos pacientes mejoran con la administracioacuten de corticosteroides La predisponga en dosis de 1mg kgdiacutea resulta eficaz en la mejoriacutea de la debilidad muscular

Plasmafeacuteresis La PF es uacutetil y eficaz en pacientes con compromiso respiratorio o bulbar que ponen en riesgo la vida del paciente Tambieacuten se utiliza para preparar al paciente previo a la timectomiacutea y acelerar la recuperacioacuten en casos de crisis miasteacutenicas

Inmunoglobulina Recientemente se ha utilizado inmunoglobulina endovenosa (Igev) en grandes dosis con buenos resultados en pacientes con MG La dosis administrada es de 04 gkgdiacutea durante cinco diacuteas consecutivos y los beneficios son transitorios

Inmunosupresores La azatioprina es efectiva en dosis de 2-3 mgkgdiacutea Se puede realizar sola o combinada con los corticosteroides

Timectomiacutea La timectomiacutea es maacutes eficaz en adultos joacutevenes (lt40 antildeos) con MG generalizada pero tambieacuten se benefician de ella otros pacientes En pacientes con MGO los beneficios de la timectomiacutea no son tan obvios y existe una demora de seis meses a varios antildeos en la observacioacuten de los beneficios de eacutesta

Abstract Myasthenia gravis is often difficult to diagnose and treat in older

subjects due to complications previous history and reciprocal interaction with drugs used to treat complications An 84-year-old woman with slowly progressive 2-year dysphagia and dysarthria had reached critical condition with aspiration pneumonia She was diagnosed with thymoma-free myasthenia gravis and her respirator removed after being administrated an anticholinesterase drug Her dysphagia and dysarthria did not improve Because of severe osteoporosis with two previous lumbar compression fractures and excessive thinness she could not be given prednisolone or immunosuppressive drugs Following cricopharyngeal myotomy and bilateral lateral palatopharyngeal wall narrowing she could eat without misdeglutition and speak clearly

El articulo nos habla que es mas difiacutecil de tratar y diagnosticar a persona de edad mayor porque puede tener complicaciones Nos habla de una mujer de 84 antildeos que tenia disfasia por 2 antildeos y con neumoniacutea por aspiracioacuten y le descubrieron miastenia gravis Fue mucho mas difiacutecil el tratamiento de su enfermedad y la edad

Abstract

Antititin antibody occurs in the serum of myasthenia gravis (MG) patients with thymoma (MGT) and is a diagnostic marker for the disease The mechanism that triggers MGT development is however unclear This study evaluated the role of the main immunogenic region (MIR) of titin in MGT pathogenesis Titin MIR antiserum (antibody titre 116) was obtained and an in situ immunohistochemical study of thymomatous tissue samples was performed Strong immunostaining for titin MIR was observed on epithelial cell membranes in MGT patients and the degree of immunostaining was directly proportional to the number of epithelial cells in thymomatous tissue Serum antititin antibody levels were closely related to titin MIR levels in thymoma cells however titin MIR levels did not appear to be related to MG severity Antititin antibody may be a good surrogate marker for thymoma but is probably not involved in the pathogenesis of MGT

El articulo nos habla Anticuerpos Antititin se produce en el suero de la miasteniaGravis es un marcador para diagnosticar las enfermedades sin embargo no esta Claro pero este estudio evaluoacute el papel de la principal regioacuten inmunogeacutenica Losniveles seacutericos de anticuerpos antititin estaban estrechamente relacionados con los niveles de titina MIR en las ceacutelulas de timoma

Abstract

Dysphagia as the sole manifestation of myasthenia gravis is very rare Here we describe a case of an adult patient who developed an insidious onset of oropharyngeal dysphagia as the first and sole manifestation of myasthenia gravis After multiple evaluations the underlying disease was recognized by electromyographics studies English and Spanish literature on the matter was reviewed

El articulo nos describe el caso de un paciente adulto que desarrolloacute un inicio insidioso de la disfagia orofariacutengea como la manifestacioacuten primera y uacutenica de la miastenia gravis Despueacutes de las evaluaciones muacuteltiples de la enfermedad subyacente fue reconocido por los estudios electromiografiacutea

Abstract We report two female patients with neuromyelitis optica (NMO Devics

syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgWe report two female patients with neuromyelitis optica (NMO Devics syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgG autoantibody against aquaporin-4 water channel was absent from their sera Both NMO and MG are relatively rare diseases The considerable coincidence of these two disorders suggests that there is a subgroup of patients with NMO having a common immunological pathogenesis with MG

El articulo nos habla sobre dos mujeres la cual presentan neuromielitis optica que hace referencia con la miastenia gravis estas enfermedades se caracterizan por mielitis subaguda con neuritis oacuteptica los altos niveles seacutericos de anticuerpos del receptor de acetilcolina del muacutesculo y la enfermedad tiroidea autoinmune

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

Prueba farmacoloacutegica La primera prueba diagnoacutestica se realiza generalmente con el cloruro de edrofonio (prueba de Tensilon) endovenoso La dosis inicial es de 1mg seguida de 23 y 5 mg en intervalos de 3 a 5 minutos Se debe disponer de una jeringa con atropina para controlar los siacutentomas gastrointestinales o en casos raros de bradicardia e hipotensioacuten

Pruebas electrofisioloacutegicas La estimulacioacuten repetitiva de distintos nervios es el meacutetodo electrofisioloacutegico maacutes frecuentemente utilizado para detectar una alteracioacuten de la transmisioacuten neuromuscular La temperatura del miembro que se va a estudiar debe ser mayor de 34degC y el paciente debe abstenerse de tomar inhibidores de la colinsterasa 12 horas antes del estudio

Anticuerpos contra receptores de acetilcolina La presencia de ACRA en pacientes con manifestaciones cliacutenicas compatibles o caracteriacutesticas de la MG confirma el diagnoacutestico Existen tres tipos de anticuerpos bloqueantes moduladores y de ligadura

Estudios radioloacutegicos Un 10 de los pacientes de MG padecen timomas La mayoriacutea de estos tumores son benignos pero son localmente invasores Por esta razoacuten se recomienda obtener una tomografiacutea computarizada o una resonancia magneacutetica de torax en todo paciente diagnosticado con MG

Faacutermacos anticolinesteraacutesicos Este grupo de sustancia prolonga la accioacuten de la acetilcolina en la unioacuten neuromuscular y mejora la debilidad muscular en cierto grupo de pacientes con MG El bromuro de piridostigmina (Mestinon) se utiliza frecuentemente en dosis de 30-60mg cada 3 a 6 horas

Corticosteroides Muchos pacientes mejoran con la administracioacuten de corticosteroides La predisponga en dosis de 1mg kgdiacutea resulta eficaz en la mejoriacutea de la debilidad muscular

Plasmafeacuteresis La PF es uacutetil y eficaz en pacientes con compromiso respiratorio o bulbar que ponen en riesgo la vida del paciente Tambieacuten se utiliza para preparar al paciente previo a la timectomiacutea y acelerar la recuperacioacuten en casos de crisis miasteacutenicas

Inmunoglobulina Recientemente se ha utilizado inmunoglobulina endovenosa (Igev) en grandes dosis con buenos resultados en pacientes con MG La dosis administrada es de 04 gkgdiacutea durante cinco diacuteas consecutivos y los beneficios son transitorios

Inmunosupresores La azatioprina es efectiva en dosis de 2-3 mgkgdiacutea Se puede realizar sola o combinada con los corticosteroides

Timectomiacutea La timectomiacutea es maacutes eficaz en adultos joacutevenes (lt40 antildeos) con MG generalizada pero tambieacuten se benefician de ella otros pacientes En pacientes con MGO los beneficios de la timectomiacutea no son tan obvios y existe una demora de seis meses a varios antildeos en la observacioacuten de los beneficios de eacutesta

Abstract Myasthenia gravis is often difficult to diagnose and treat in older

subjects due to complications previous history and reciprocal interaction with drugs used to treat complications An 84-year-old woman with slowly progressive 2-year dysphagia and dysarthria had reached critical condition with aspiration pneumonia She was diagnosed with thymoma-free myasthenia gravis and her respirator removed after being administrated an anticholinesterase drug Her dysphagia and dysarthria did not improve Because of severe osteoporosis with two previous lumbar compression fractures and excessive thinness she could not be given prednisolone or immunosuppressive drugs Following cricopharyngeal myotomy and bilateral lateral palatopharyngeal wall narrowing she could eat without misdeglutition and speak clearly

El articulo nos habla que es mas difiacutecil de tratar y diagnosticar a persona de edad mayor porque puede tener complicaciones Nos habla de una mujer de 84 antildeos que tenia disfasia por 2 antildeos y con neumoniacutea por aspiracioacuten y le descubrieron miastenia gravis Fue mucho mas difiacutecil el tratamiento de su enfermedad y la edad

Abstract

Antititin antibody occurs in the serum of myasthenia gravis (MG) patients with thymoma (MGT) and is a diagnostic marker for the disease The mechanism that triggers MGT development is however unclear This study evaluated the role of the main immunogenic region (MIR) of titin in MGT pathogenesis Titin MIR antiserum (antibody titre 116) was obtained and an in situ immunohistochemical study of thymomatous tissue samples was performed Strong immunostaining for titin MIR was observed on epithelial cell membranes in MGT patients and the degree of immunostaining was directly proportional to the number of epithelial cells in thymomatous tissue Serum antititin antibody levels were closely related to titin MIR levels in thymoma cells however titin MIR levels did not appear to be related to MG severity Antititin antibody may be a good surrogate marker for thymoma but is probably not involved in the pathogenesis of MGT

El articulo nos habla Anticuerpos Antititin se produce en el suero de la miasteniaGravis es un marcador para diagnosticar las enfermedades sin embargo no esta Claro pero este estudio evaluoacute el papel de la principal regioacuten inmunogeacutenica Losniveles seacutericos de anticuerpos antititin estaban estrechamente relacionados con los niveles de titina MIR en las ceacutelulas de timoma

Abstract

Dysphagia as the sole manifestation of myasthenia gravis is very rare Here we describe a case of an adult patient who developed an insidious onset of oropharyngeal dysphagia as the first and sole manifestation of myasthenia gravis After multiple evaluations the underlying disease was recognized by electromyographics studies English and Spanish literature on the matter was reviewed

El articulo nos describe el caso de un paciente adulto que desarrolloacute un inicio insidioso de la disfagia orofariacutengea como la manifestacioacuten primera y uacutenica de la miastenia gravis Despueacutes de las evaluaciones muacuteltiples de la enfermedad subyacente fue reconocido por los estudios electromiografiacutea

Abstract We report two female patients with neuromyelitis optica (NMO Devics

syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgWe report two female patients with neuromyelitis optica (NMO Devics syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgG autoantibody against aquaporin-4 water channel was absent from their sera Both NMO and MG are relatively rare diseases The considerable coincidence of these two disorders suggests that there is a subgroup of patients with NMO having a common immunological pathogenesis with MG

El articulo nos habla sobre dos mujeres la cual presentan neuromielitis optica que hace referencia con la miastenia gravis estas enfermedades se caracterizan por mielitis subaguda con neuritis oacuteptica los altos niveles seacutericos de anticuerpos del receptor de acetilcolina del muacutesculo y la enfermedad tiroidea autoinmune

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

Anticuerpos contra receptores de acetilcolina La presencia de ACRA en pacientes con manifestaciones cliacutenicas compatibles o caracteriacutesticas de la MG confirma el diagnoacutestico Existen tres tipos de anticuerpos bloqueantes moduladores y de ligadura

Estudios radioloacutegicos Un 10 de los pacientes de MG padecen timomas La mayoriacutea de estos tumores son benignos pero son localmente invasores Por esta razoacuten se recomienda obtener una tomografiacutea computarizada o una resonancia magneacutetica de torax en todo paciente diagnosticado con MG

Faacutermacos anticolinesteraacutesicos Este grupo de sustancia prolonga la accioacuten de la acetilcolina en la unioacuten neuromuscular y mejora la debilidad muscular en cierto grupo de pacientes con MG El bromuro de piridostigmina (Mestinon) se utiliza frecuentemente en dosis de 30-60mg cada 3 a 6 horas

Corticosteroides Muchos pacientes mejoran con la administracioacuten de corticosteroides La predisponga en dosis de 1mg kgdiacutea resulta eficaz en la mejoriacutea de la debilidad muscular

Plasmafeacuteresis La PF es uacutetil y eficaz en pacientes con compromiso respiratorio o bulbar que ponen en riesgo la vida del paciente Tambieacuten se utiliza para preparar al paciente previo a la timectomiacutea y acelerar la recuperacioacuten en casos de crisis miasteacutenicas

Inmunoglobulina Recientemente se ha utilizado inmunoglobulina endovenosa (Igev) en grandes dosis con buenos resultados en pacientes con MG La dosis administrada es de 04 gkgdiacutea durante cinco diacuteas consecutivos y los beneficios son transitorios

Inmunosupresores La azatioprina es efectiva en dosis de 2-3 mgkgdiacutea Se puede realizar sola o combinada con los corticosteroides

Timectomiacutea La timectomiacutea es maacutes eficaz en adultos joacutevenes (lt40 antildeos) con MG generalizada pero tambieacuten se benefician de ella otros pacientes En pacientes con MGO los beneficios de la timectomiacutea no son tan obvios y existe una demora de seis meses a varios antildeos en la observacioacuten de los beneficios de eacutesta

Abstract Myasthenia gravis is often difficult to diagnose and treat in older

subjects due to complications previous history and reciprocal interaction with drugs used to treat complications An 84-year-old woman with slowly progressive 2-year dysphagia and dysarthria had reached critical condition with aspiration pneumonia She was diagnosed with thymoma-free myasthenia gravis and her respirator removed after being administrated an anticholinesterase drug Her dysphagia and dysarthria did not improve Because of severe osteoporosis with two previous lumbar compression fractures and excessive thinness she could not be given prednisolone or immunosuppressive drugs Following cricopharyngeal myotomy and bilateral lateral palatopharyngeal wall narrowing she could eat without misdeglutition and speak clearly

El articulo nos habla que es mas difiacutecil de tratar y diagnosticar a persona de edad mayor porque puede tener complicaciones Nos habla de una mujer de 84 antildeos que tenia disfasia por 2 antildeos y con neumoniacutea por aspiracioacuten y le descubrieron miastenia gravis Fue mucho mas difiacutecil el tratamiento de su enfermedad y la edad

Abstract

Antititin antibody occurs in the serum of myasthenia gravis (MG) patients with thymoma (MGT) and is a diagnostic marker for the disease The mechanism that triggers MGT development is however unclear This study evaluated the role of the main immunogenic region (MIR) of titin in MGT pathogenesis Titin MIR antiserum (antibody titre 116) was obtained and an in situ immunohistochemical study of thymomatous tissue samples was performed Strong immunostaining for titin MIR was observed on epithelial cell membranes in MGT patients and the degree of immunostaining was directly proportional to the number of epithelial cells in thymomatous tissue Serum antititin antibody levels were closely related to titin MIR levels in thymoma cells however titin MIR levels did not appear to be related to MG severity Antititin antibody may be a good surrogate marker for thymoma but is probably not involved in the pathogenesis of MGT

El articulo nos habla Anticuerpos Antititin se produce en el suero de la miasteniaGravis es un marcador para diagnosticar las enfermedades sin embargo no esta Claro pero este estudio evaluoacute el papel de la principal regioacuten inmunogeacutenica Losniveles seacutericos de anticuerpos antititin estaban estrechamente relacionados con los niveles de titina MIR en las ceacutelulas de timoma

Abstract

Dysphagia as the sole manifestation of myasthenia gravis is very rare Here we describe a case of an adult patient who developed an insidious onset of oropharyngeal dysphagia as the first and sole manifestation of myasthenia gravis After multiple evaluations the underlying disease was recognized by electromyographics studies English and Spanish literature on the matter was reviewed

El articulo nos describe el caso de un paciente adulto que desarrolloacute un inicio insidioso de la disfagia orofariacutengea como la manifestacioacuten primera y uacutenica de la miastenia gravis Despueacutes de las evaluaciones muacuteltiples de la enfermedad subyacente fue reconocido por los estudios electromiografiacutea

Abstract We report two female patients with neuromyelitis optica (NMO Devics

syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgWe report two female patients with neuromyelitis optica (NMO Devics syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgG autoantibody against aquaporin-4 water channel was absent from their sera Both NMO and MG are relatively rare diseases The considerable coincidence of these two disorders suggests that there is a subgroup of patients with NMO having a common immunological pathogenesis with MG

El articulo nos habla sobre dos mujeres la cual presentan neuromielitis optica que hace referencia con la miastenia gravis estas enfermedades se caracterizan por mielitis subaguda con neuritis oacuteptica los altos niveles seacutericos de anticuerpos del receptor de acetilcolina del muacutesculo y la enfermedad tiroidea autoinmune

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

Faacutermacos anticolinesteraacutesicos Este grupo de sustancia prolonga la accioacuten de la acetilcolina en la unioacuten neuromuscular y mejora la debilidad muscular en cierto grupo de pacientes con MG El bromuro de piridostigmina (Mestinon) se utiliza frecuentemente en dosis de 30-60mg cada 3 a 6 horas

Corticosteroides Muchos pacientes mejoran con la administracioacuten de corticosteroides La predisponga en dosis de 1mg kgdiacutea resulta eficaz en la mejoriacutea de la debilidad muscular

Plasmafeacuteresis La PF es uacutetil y eficaz en pacientes con compromiso respiratorio o bulbar que ponen en riesgo la vida del paciente Tambieacuten se utiliza para preparar al paciente previo a la timectomiacutea y acelerar la recuperacioacuten en casos de crisis miasteacutenicas

Inmunoglobulina Recientemente se ha utilizado inmunoglobulina endovenosa (Igev) en grandes dosis con buenos resultados en pacientes con MG La dosis administrada es de 04 gkgdiacutea durante cinco diacuteas consecutivos y los beneficios son transitorios

Inmunosupresores La azatioprina es efectiva en dosis de 2-3 mgkgdiacutea Se puede realizar sola o combinada con los corticosteroides

Timectomiacutea La timectomiacutea es maacutes eficaz en adultos joacutevenes (lt40 antildeos) con MG generalizada pero tambieacuten se benefician de ella otros pacientes En pacientes con MGO los beneficios de la timectomiacutea no son tan obvios y existe una demora de seis meses a varios antildeos en la observacioacuten de los beneficios de eacutesta

Abstract Myasthenia gravis is often difficult to diagnose and treat in older

subjects due to complications previous history and reciprocal interaction with drugs used to treat complications An 84-year-old woman with slowly progressive 2-year dysphagia and dysarthria had reached critical condition with aspiration pneumonia She was diagnosed with thymoma-free myasthenia gravis and her respirator removed after being administrated an anticholinesterase drug Her dysphagia and dysarthria did not improve Because of severe osteoporosis with two previous lumbar compression fractures and excessive thinness she could not be given prednisolone or immunosuppressive drugs Following cricopharyngeal myotomy and bilateral lateral palatopharyngeal wall narrowing she could eat without misdeglutition and speak clearly

El articulo nos habla que es mas difiacutecil de tratar y diagnosticar a persona de edad mayor porque puede tener complicaciones Nos habla de una mujer de 84 antildeos que tenia disfasia por 2 antildeos y con neumoniacutea por aspiracioacuten y le descubrieron miastenia gravis Fue mucho mas difiacutecil el tratamiento de su enfermedad y la edad

Abstract

Antititin antibody occurs in the serum of myasthenia gravis (MG) patients with thymoma (MGT) and is a diagnostic marker for the disease The mechanism that triggers MGT development is however unclear This study evaluated the role of the main immunogenic region (MIR) of titin in MGT pathogenesis Titin MIR antiserum (antibody titre 116) was obtained and an in situ immunohistochemical study of thymomatous tissue samples was performed Strong immunostaining for titin MIR was observed on epithelial cell membranes in MGT patients and the degree of immunostaining was directly proportional to the number of epithelial cells in thymomatous tissue Serum antititin antibody levels were closely related to titin MIR levels in thymoma cells however titin MIR levels did not appear to be related to MG severity Antititin antibody may be a good surrogate marker for thymoma but is probably not involved in the pathogenesis of MGT

El articulo nos habla Anticuerpos Antititin se produce en el suero de la miasteniaGravis es un marcador para diagnosticar las enfermedades sin embargo no esta Claro pero este estudio evaluoacute el papel de la principal regioacuten inmunogeacutenica Losniveles seacutericos de anticuerpos antititin estaban estrechamente relacionados con los niveles de titina MIR en las ceacutelulas de timoma

Abstract

Dysphagia as the sole manifestation of myasthenia gravis is very rare Here we describe a case of an adult patient who developed an insidious onset of oropharyngeal dysphagia as the first and sole manifestation of myasthenia gravis After multiple evaluations the underlying disease was recognized by electromyographics studies English and Spanish literature on the matter was reviewed

El articulo nos describe el caso de un paciente adulto que desarrolloacute un inicio insidioso de la disfagia orofariacutengea como la manifestacioacuten primera y uacutenica de la miastenia gravis Despueacutes de las evaluaciones muacuteltiples de la enfermedad subyacente fue reconocido por los estudios electromiografiacutea

Abstract We report two female patients with neuromyelitis optica (NMO Devics

syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgWe report two female patients with neuromyelitis optica (NMO Devics syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgG autoantibody against aquaporin-4 water channel was absent from their sera Both NMO and MG are relatively rare diseases The considerable coincidence of these two disorders suggests that there is a subgroup of patients with NMO having a common immunological pathogenesis with MG

El articulo nos habla sobre dos mujeres la cual presentan neuromielitis optica que hace referencia con la miastenia gravis estas enfermedades se caracterizan por mielitis subaguda con neuritis oacuteptica los altos niveles seacutericos de anticuerpos del receptor de acetilcolina del muacutesculo y la enfermedad tiroidea autoinmune

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

Plasmafeacuteresis La PF es uacutetil y eficaz en pacientes con compromiso respiratorio o bulbar que ponen en riesgo la vida del paciente Tambieacuten se utiliza para preparar al paciente previo a la timectomiacutea y acelerar la recuperacioacuten en casos de crisis miasteacutenicas

Inmunoglobulina Recientemente se ha utilizado inmunoglobulina endovenosa (Igev) en grandes dosis con buenos resultados en pacientes con MG La dosis administrada es de 04 gkgdiacutea durante cinco diacuteas consecutivos y los beneficios son transitorios

Inmunosupresores La azatioprina es efectiva en dosis de 2-3 mgkgdiacutea Se puede realizar sola o combinada con los corticosteroides

Timectomiacutea La timectomiacutea es maacutes eficaz en adultos joacutevenes (lt40 antildeos) con MG generalizada pero tambieacuten se benefician de ella otros pacientes En pacientes con MGO los beneficios de la timectomiacutea no son tan obvios y existe una demora de seis meses a varios antildeos en la observacioacuten de los beneficios de eacutesta

Abstract Myasthenia gravis is often difficult to diagnose and treat in older

subjects due to complications previous history and reciprocal interaction with drugs used to treat complications An 84-year-old woman with slowly progressive 2-year dysphagia and dysarthria had reached critical condition with aspiration pneumonia She was diagnosed with thymoma-free myasthenia gravis and her respirator removed after being administrated an anticholinesterase drug Her dysphagia and dysarthria did not improve Because of severe osteoporosis with two previous lumbar compression fractures and excessive thinness she could not be given prednisolone or immunosuppressive drugs Following cricopharyngeal myotomy and bilateral lateral palatopharyngeal wall narrowing she could eat without misdeglutition and speak clearly

El articulo nos habla que es mas difiacutecil de tratar y diagnosticar a persona de edad mayor porque puede tener complicaciones Nos habla de una mujer de 84 antildeos que tenia disfasia por 2 antildeos y con neumoniacutea por aspiracioacuten y le descubrieron miastenia gravis Fue mucho mas difiacutecil el tratamiento de su enfermedad y la edad

Abstract

Antititin antibody occurs in the serum of myasthenia gravis (MG) patients with thymoma (MGT) and is a diagnostic marker for the disease The mechanism that triggers MGT development is however unclear This study evaluated the role of the main immunogenic region (MIR) of titin in MGT pathogenesis Titin MIR antiserum (antibody titre 116) was obtained and an in situ immunohistochemical study of thymomatous tissue samples was performed Strong immunostaining for titin MIR was observed on epithelial cell membranes in MGT patients and the degree of immunostaining was directly proportional to the number of epithelial cells in thymomatous tissue Serum antititin antibody levels were closely related to titin MIR levels in thymoma cells however titin MIR levels did not appear to be related to MG severity Antititin antibody may be a good surrogate marker for thymoma but is probably not involved in the pathogenesis of MGT

El articulo nos habla Anticuerpos Antititin se produce en el suero de la miasteniaGravis es un marcador para diagnosticar las enfermedades sin embargo no esta Claro pero este estudio evaluoacute el papel de la principal regioacuten inmunogeacutenica Losniveles seacutericos de anticuerpos antititin estaban estrechamente relacionados con los niveles de titina MIR en las ceacutelulas de timoma

Abstract

Dysphagia as the sole manifestation of myasthenia gravis is very rare Here we describe a case of an adult patient who developed an insidious onset of oropharyngeal dysphagia as the first and sole manifestation of myasthenia gravis After multiple evaluations the underlying disease was recognized by electromyographics studies English and Spanish literature on the matter was reviewed

El articulo nos describe el caso de un paciente adulto que desarrolloacute un inicio insidioso de la disfagia orofariacutengea como la manifestacioacuten primera y uacutenica de la miastenia gravis Despueacutes de las evaluaciones muacuteltiples de la enfermedad subyacente fue reconocido por los estudios electromiografiacutea

Abstract We report two female patients with neuromyelitis optica (NMO Devics

syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgWe report two female patients with neuromyelitis optica (NMO Devics syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgG autoantibody against aquaporin-4 water channel was absent from their sera Both NMO and MG are relatively rare diseases The considerable coincidence of these two disorders suggests that there is a subgroup of patients with NMO having a common immunological pathogenesis with MG

El articulo nos habla sobre dos mujeres la cual presentan neuromielitis optica que hace referencia con la miastenia gravis estas enfermedades se caracterizan por mielitis subaguda con neuritis oacuteptica los altos niveles seacutericos de anticuerpos del receptor de acetilcolina del muacutesculo y la enfermedad tiroidea autoinmune

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

Inmunosupresores La azatioprina es efectiva en dosis de 2-3 mgkgdiacutea Se puede realizar sola o combinada con los corticosteroides

Timectomiacutea La timectomiacutea es maacutes eficaz en adultos joacutevenes (lt40 antildeos) con MG generalizada pero tambieacuten se benefician de ella otros pacientes En pacientes con MGO los beneficios de la timectomiacutea no son tan obvios y existe una demora de seis meses a varios antildeos en la observacioacuten de los beneficios de eacutesta

Abstract Myasthenia gravis is often difficult to diagnose and treat in older

subjects due to complications previous history and reciprocal interaction with drugs used to treat complications An 84-year-old woman with slowly progressive 2-year dysphagia and dysarthria had reached critical condition with aspiration pneumonia She was diagnosed with thymoma-free myasthenia gravis and her respirator removed after being administrated an anticholinesterase drug Her dysphagia and dysarthria did not improve Because of severe osteoporosis with two previous lumbar compression fractures and excessive thinness she could not be given prednisolone or immunosuppressive drugs Following cricopharyngeal myotomy and bilateral lateral palatopharyngeal wall narrowing she could eat without misdeglutition and speak clearly

El articulo nos habla que es mas difiacutecil de tratar y diagnosticar a persona de edad mayor porque puede tener complicaciones Nos habla de una mujer de 84 antildeos que tenia disfasia por 2 antildeos y con neumoniacutea por aspiracioacuten y le descubrieron miastenia gravis Fue mucho mas difiacutecil el tratamiento de su enfermedad y la edad

Abstract

Antititin antibody occurs in the serum of myasthenia gravis (MG) patients with thymoma (MGT) and is a diagnostic marker for the disease The mechanism that triggers MGT development is however unclear This study evaluated the role of the main immunogenic region (MIR) of titin in MGT pathogenesis Titin MIR antiserum (antibody titre 116) was obtained and an in situ immunohistochemical study of thymomatous tissue samples was performed Strong immunostaining for titin MIR was observed on epithelial cell membranes in MGT patients and the degree of immunostaining was directly proportional to the number of epithelial cells in thymomatous tissue Serum antititin antibody levels were closely related to titin MIR levels in thymoma cells however titin MIR levels did not appear to be related to MG severity Antititin antibody may be a good surrogate marker for thymoma but is probably not involved in the pathogenesis of MGT

El articulo nos habla Anticuerpos Antititin se produce en el suero de la miasteniaGravis es un marcador para diagnosticar las enfermedades sin embargo no esta Claro pero este estudio evaluoacute el papel de la principal regioacuten inmunogeacutenica Losniveles seacutericos de anticuerpos antititin estaban estrechamente relacionados con los niveles de titina MIR en las ceacutelulas de timoma

Abstract

Dysphagia as the sole manifestation of myasthenia gravis is very rare Here we describe a case of an adult patient who developed an insidious onset of oropharyngeal dysphagia as the first and sole manifestation of myasthenia gravis After multiple evaluations the underlying disease was recognized by electromyographics studies English and Spanish literature on the matter was reviewed

El articulo nos describe el caso de un paciente adulto que desarrolloacute un inicio insidioso de la disfagia orofariacutengea como la manifestacioacuten primera y uacutenica de la miastenia gravis Despueacutes de las evaluaciones muacuteltiples de la enfermedad subyacente fue reconocido por los estudios electromiografiacutea

Abstract We report two female patients with neuromyelitis optica (NMO Devics

syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgWe report two female patients with neuromyelitis optica (NMO Devics syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgG autoantibody against aquaporin-4 water channel was absent from their sera Both NMO and MG are relatively rare diseases The considerable coincidence of these two disorders suggests that there is a subgroup of patients with NMO having a common immunological pathogenesis with MG

El articulo nos habla sobre dos mujeres la cual presentan neuromielitis optica que hace referencia con la miastenia gravis estas enfermedades se caracterizan por mielitis subaguda con neuritis oacuteptica los altos niveles seacutericos de anticuerpos del receptor de acetilcolina del muacutesculo y la enfermedad tiroidea autoinmune

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

Abstract Myasthenia gravis is often difficult to diagnose and treat in older

subjects due to complications previous history and reciprocal interaction with drugs used to treat complications An 84-year-old woman with slowly progressive 2-year dysphagia and dysarthria had reached critical condition with aspiration pneumonia She was diagnosed with thymoma-free myasthenia gravis and her respirator removed after being administrated an anticholinesterase drug Her dysphagia and dysarthria did not improve Because of severe osteoporosis with two previous lumbar compression fractures and excessive thinness she could not be given prednisolone or immunosuppressive drugs Following cricopharyngeal myotomy and bilateral lateral palatopharyngeal wall narrowing she could eat without misdeglutition and speak clearly

El articulo nos habla que es mas difiacutecil de tratar y diagnosticar a persona de edad mayor porque puede tener complicaciones Nos habla de una mujer de 84 antildeos que tenia disfasia por 2 antildeos y con neumoniacutea por aspiracioacuten y le descubrieron miastenia gravis Fue mucho mas difiacutecil el tratamiento de su enfermedad y la edad

Abstract

Antititin antibody occurs in the serum of myasthenia gravis (MG) patients with thymoma (MGT) and is a diagnostic marker for the disease The mechanism that triggers MGT development is however unclear This study evaluated the role of the main immunogenic region (MIR) of titin in MGT pathogenesis Titin MIR antiserum (antibody titre 116) was obtained and an in situ immunohistochemical study of thymomatous tissue samples was performed Strong immunostaining for titin MIR was observed on epithelial cell membranes in MGT patients and the degree of immunostaining was directly proportional to the number of epithelial cells in thymomatous tissue Serum antititin antibody levels were closely related to titin MIR levels in thymoma cells however titin MIR levels did not appear to be related to MG severity Antititin antibody may be a good surrogate marker for thymoma but is probably not involved in the pathogenesis of MGT

El articulo nos habla Anticuerpos Antititin se produce en el suero de la miasteniaGravis es un marcador para diagnosticar las enfermedades sin embargo no esta Claro pero este estudio evaluoacute el papel de la principal regioacuten inmunogeacutenica Losniveles seacutericos de anticuerpos antititin estaban estrechamente relacionados con los niveles de titina MIR en las ceacutelulas de timoma

Abstract

Dysphagia as the sole manifestation of myasthenia gravis is very rare Here we describe a case of an adult patient who developed an insidious onset of oropharyngeal dysphagia as the first and sole manifestation of myasthenia gravis After multiple evaluations the underlying disease was recognized by electromyographics studies English and Spanish literature on the matter was reviewed

El articulo nos describe el caso de un paciente adulto que desarrolloacute un inicio insidioso de la disfagia orofariacutengea como la manifestacioacuten primera y uacutenica de la miastenia gravis Despueacutes de las evaluaciones muacuteltiples de la enfermedad subyacente fue reconocido por los estudios electromiografiacutea

Abstract We report two female patients with neuromyelitis optica (NMO Devics

syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgWe report two female patients with neuromyelitis optica (NMO Devics syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgG autoantibody against aquaporin-4 water channel was absent from their sera Both NMO and MG are relatively rare diseases The considerable coincidence of these two disorders suggests that there is a subgroup of patients with NMO having a common immunological pathogenesis with MG

El articulo nos habla sobre dos mujeres la cual presentan neuromielitis optica que hace referencia con la miastenia gravis estas enfermedades se caracterizan por mielitis subaguda con neuritis oacuteptica los altos niveles seacutericos de anticuerpos del receptor de acetilcolina del muacutesculo y la enfermedad tiroidea autoinmune

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

El articulo nos habla que es mas difiacutecil de tratar y diagnosticar a persona de edad mayor porque puede tener complicaciones Nos habla de una mujer de 84 antildeos que tenia disfasia por 2 antildeos y con neumoniacutea por aspiracioacuten y le descubrieron miastenia gravis Fue mucho mas difiacutecil el tratamiento de su enfermedad y la edad

Abstract

Antititin antibody occurs in the serum of myasthenia gravis (MG) patients with thymoma (MGT) and is a diagnostic marker for the disease The mechanism that triggers MGT development is however unclear This study evaluated the role of the main immunogenic region (MIR) of titin in MGT pathogenesis Titin MIR antiserum (antibody titre 116) was obtained and an in situ immunohistochemical study of thymomatous tissue samples was performed Strong immunostaining for titin MIR was observed on epithelial cell membranes in MGT patients and the degree of immunostaining was directly proportional to the number of epithelial cells in thymomatous tissue Serum antititin antibody levels were closely related to titin MIR levels in thymoma cells however titin MIR levels did not appear to be related to MG severity Antititin antibody may be a good surrogate marker for thymoma but is probably not involved in the pathogenesis of MGT

El articulo nos habla Anticuerpos Antititin se produce en el suero de la miasteniaGravis es un marcador para diagnosticar las enfermedades sin embargo no esta Claro pero este estudio evaluoacute el papel de la principal regioacuten inmunogeacutenica Losniveles seacutericos de anticuerpos antititin estaban estrechamente relacionados con los niveles de titina MIR en las ceacutelulas de timoma

Abstract

Dysphagia as the sole manifestation of myasthenia gravis is very rare Here we describe a case of an adult patient who developed an insidious onset of oropharyngeal dysphagia as the first and sole manifestation of myasthenia gravis After multiple evaluations the underlying disease was recognized by electromyographics studies English and Spanish literature on the matter was reviewed

El articulo nos describe el caso de un paciente adulto que desarrolloacute un inicio insidioso de la disfagia orofariacutengea como la manifestacioacuten primera y uacutenica de la miastenia gravis Despueacutes de las evaluaciones muacuteltiples de la enfermedad subyacente fue reconocido por los estudios electromiografiacutea

Abstract We report two female patients with neuromyelitis optica (NMO Devics

syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgWe report two female patients with neuromyelitis optica (NMO Devics syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgG autoantibody against aquaporin-4 water channel was absent from their sera Both NMO and MG are relatively rare diseases The considerable coincidence of these two disorders suggests that there is a subgroup of patients with NMO having a common immunological pathogenesis with MG

El articulo nos habla sobre dos mujeres la cual presentan neuromielitis optica que hace referencia con la miastenia gravis estas enfermedades se caracterizan por mielitis subaguda con neuritis oacuteptica los altos niveles seacutericos de anticuerpos del receptor de acetilcolina del muacutesculo y la enfermedad tiroidea autoinmune

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

Abstract

Antititin antibody occurs in the serum of myasthenia gravis (MG) patients with thymoma (MGT) and is a diagnostic marker for the disease The mechanism that triggers MGT development is however unclear This study evaluated the role of the main immunogenic region (MIR) of titin in MGT pathogenesis Titin MIR antiserum (antibody titre 116) was obtained and an in situ immunohistochemical study of thymomatous tissue samples was performed Strong immunostaining for titin MIR was observed on epithelial cell membranes in MGT patients and the degree of immunostaining was directly proportional to the number of epithelial cells in thymomatous tissue Serum antititin antibody levels were closely related to titin MIR levels in thymoma cells however titin MIR levels did not appear to be related to MG severity Antititin antibody may be a good surrogate marker for thymoma but is probably not involved in the pathogenesis of MGT

El articulo nos habla Anticuerpos Antititin se produce en el suero de la miasteniaGravis es un marcador para diagnosticar las enfermedades sin embargo no esta Claro pero este estudio evaluoacute el papel de la principal regioacuten inmunogeacutenica Losniveles seacutericos de anticuerpos antititin estaban estrechamente relacionados con los niveles de titina MIR en las ceacutelulas de timoma

Abstract

Dysphagia as the sole manifestation of myasthenia gravis is very rare Here we describe a case of an adult patient who developed an insidious onset of oropharyngeal dysphagia as the first and sole manifestation of myasthenia gravis After multiple evaluations the underlying disease was recognized by electromyographics studies English and Spanish literature on the matter was reviewed

El articulo nos describe el caso de un paciente adulto que desarrolloacute un inicio insidioso de la disfagia orofariacutengea como la manifestacioacuten primera y uacutenica de la miastenia gravis Despueacutes de las evaluaciones muacuteltiples de la enfermedad subyacente fue reconocido por los estudios electromiografiacutea

Abstract We report two female patients with neuromyelitis optica (NMO Devics

syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgWe report two female patients with neuromyelitis optica (NMO Devics syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgG autoantibody against aquaporin-4 water channel was absent from their sera Both NMO and MG are relatively rare diseases The considerable coincidence of these two disorders suggests that there is a subgroup of patients with NMO having a common immunological pathogenesis with MG

El articulo nos habla sobre dos mujeres la cual presentan neuromielitis optica que hace referencia con la miastenia gravis estas enfermedades se caracterizan por mielitis subaguda con neuritis oacuteptica los altos niveles seacutericos de anticuerpos del receptor de acetilcolina del muacutesculo y la enfermedad tiroidea autoinmune

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

El articulo nos habla Anticuerpos Antititin se produce en el suero de la miasteniaGravis es un marcador para diagnosticar las enfermedades sin embargo no esta Claro pero este estudio evaluoacute el papel de la principal regioacuten inmunogeacutenica Losniveles seacutericos de anticuerpos antititin estaban estrechamente relacionados con los niveles de titina MIR en las ceacutelulas de timoma

Abstract

Dysphagia as the sole manifestation of myasthenia gravis is very rare Here we describe a case of an adult patient who developed an insidious onset of oropharyngeal dysphagia as the first and sole manifestation of myasthenia gravis After multiple evaluations the underlying disease was recognized by electromyographics studies English and Spanish literature on the matter was reviewed

El articulo nos describe el caso de un paciente adulto que desarrolloacute un inicio insidioso de la disfagia orofariacutengea como la manifestacioacuten primera y uacutenica de la miastenia gravis Despueacutes de las evaluaciones muacuteltiples de la enfermedad subyacente fue reconocido por los estudios electromiografiacutea

Abstract We report two female patients with neuromyelitis optica (NMO Devics

syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgWe report two female patients with neuromyelitis optica (NMO Devics syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgG autoantibody against aquaporin-4 water channel was absent from their sera Both NMO and MG are relatively rare diseases The considerable coincidence of these two disorders suggests that there is a subgroup of patients with NMO having a common immunological pathogenesis with MG

El articulo nos habla sobre dos mujeres la cual presentan neuromielitis optica que hace referencia con la miastenia gravis estas enfermedades se caracterizan por mielitis subaguda con neuritis oacuteptica los altos niveles seacutericos de anticuerpos del receptor de acetilcolina del muacutesculo y la enfermedad tiroidea autoinmune

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

Abstract

Dysphagia as the sole manifestation of myasthenia gravis is very rare Here we describe a case of an adult patient who developed an insidious onset of oropharyngeal dysphagia as the first and sole manifestation of myasthenia gravis After multiple evaluations the underlying disease was recognized by electromyographics studies English and Spanish literature on the matter was reviewed

El articulo nos describe el caso de un paciente adulto que desarrolloacute un inicio insidioso de la disfagia orofariacutengea como la manifestacioacuten primera y uacutenica de la miastenia gravis Despueacutes de las evaluaciones muacuteltiples de la enfermedad subyacente fue reconocido por los estudios electromiografiacutea

Abstract We report two female patients with neuromyelitis optica (NMO Devics

syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgWe report two female patients with neuromyelitis optica (NMO Devics syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgG autoantibody against aquaporin-4 water channel was absent from their sera Both NMO and MG are relatively rare diseases The considerable coincidence of these two disorders suggests that there is a subgroup of patients with NMO having a common immunological pathogenesis with MG

El articulo nos habla sobre dos mujeres la cual presentan neuromielitis optica que hace referencia con la miastenia gravis estas enfermedades se caracterizan por mielitis subaguda con neuritis oacuteptica los altos niveles seacutericos de anticuerpos del receptor de acetilcolina del muacutesculo y la enfermedad tiroidea autoinmune

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

El articulo nos describe el caso de un paciente adulto que desarrolloacute un inicio insidioso de la disfagia orofariacutengea como la manifestacioacuten primera y uacutenica de la miastenia gravis Despueacutes de las evaluaciones muacuteltiples de la enfermedad subyacente fue reconocido por los estudios electromiografiacutea

Abstract We report two female patients with neuromyelitis optica (NMO Devics

syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgWe report two female patients with neuromyelitis optica (NMO Devics syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgG autoantibody against aquaporin-4 water channel was absent from their sera Both NMO and MG are relatively rare diseases The considerable coincidence of these two disorders suggests that there is a subgroup of patients with NMO having a common immunological pathogenesis with MG

El articulo nos habla sobre dos mujeres la cual presentan neuromielitis optica que hace referencia con la miastenia gravis estas enfermedades se caracterizan por mielitis subaguda con neuritis oacuteptica los altos niveles seacutericos de anticuerpos del receptor de acetilcolina del muacutesculo y la enfermedad tiroidea autoinmune

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

Abstract We report two female patients with neuromyelitis optica (NMO Devics

syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgWe report two female patients with neuromyelitis optica (NMO Devics syndrome) following or coincidental with myasthenia gravis (MG) Their illnesses were characterized by subacute myelitis with optic neuritis high serum levels of muscle acetylcholine receptor antibody and autoimmune thyroid disease Both patients fulfilled the clinical criteria of NMO however NMO-IgG autoantibody against aquaporin-4 water channel was absent from their sera Both NMO and MG are relatively rare diseases The considerable coincidence of these two disorders suggests that there is a subgroup of patients with NMO having a common immunological pathogenesis with MG

El articulo nos habla sobre dos mujeres la cual presentan neuromielitis optica que hace referencia con la miastenia gravis estas enfermedades se caracterizan por mielitis subaguda con neuritis oacuteptica los altos niveles seacutericos de anticuerpos del receptor de acetilcolina del muacutesculo y la enfermedad tiroidea autoinmune

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

El articulo nos habla sobre dos mujeres la cual presentan neuromielitis optica que hace referencia con la miastenia gravis estas enfermedades se caracterizan por mielitis subaguda con neuritis oacuteptica los altos niveles seacutericos de anticuerpos del receptor de acetilcolina del muacutesculo y la enfermedad tiroidea autoinmune

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

Two male infants with neonatal myasthenia gravis are described The serum of one patient and his myasthenic mother had no neuromuscular blocking activity or antinuclear globulin Striation binding globulin was positive in the serum of the mother but not the infant Eighty-two collected patients are reviewed Incidence was 12 of babies born to myasthenic mothers Onset was within 72 hours of birth Mean duration was 18 days and maximum was 47 days Nine patients died with a mean duration of 6 days and a maximum of 21 days

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

El articulo habla sobre dos bebes de la cual presentan miastenia gravis neonatal la cual el suero tanto como de la madre y del paciente no hubo ninguna actividad de bloqueo neuromuscular o globulina antinucleares de los cuales al 47 dia murieron 9 nintildeos a causa de la incompatibilidad de la globulina

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

1 Drachman DB Myasthenia gravis N Engl J Med 19943301797-8102

2 Engel AG Myasthenic syndromes In Engel AG Franzini-Armstrong C eds Myology 2 ed New York McGraw-Hill1994 P 1798-835

3 Engel AG Ohno K Milone M Sine SM Congenital myasthenic syndromes caused by mutations in acetylcholine receptor genes Neurology 199748 (Suppl 5)S28-35

4 Steinman L Mantegazza R Prospects for specific inmunotherapy in myasthenia gravis FASEB J 199042726-31

5 Massey JM Treatment of acquired myasthenia gravis Neurology 199748 (suppl 5)S46-51

6 Jaretzki A III Thymectomy for myasthenia gravis analysis of the controversies regarding technique and results Neurology 199748 (Suppl 5) S52-63

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

Titulo Dysphagia and dysarthria surgery for advanced-age myasthenia gravis

Autores Saigusa H Yamaguchi S Nakamura T Komachi T Ozu R Kadosono O Kokawa T Aino I Matsuoka C

Link httpwwwncbinlmnihgovpubmed21061568 Titulo Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Autores Thymic expression of the main immunogenic region of

titin in thymomatous myasthenia gravis Link httpwwwncbinlmnihgovpubmed20926005 Titulo AutorHealth Service Center Graduate School of Medical

Science Kanazawa University Kanazawa Japan Linkhttpbibliotecafucsaludeduco2079ehostdetail

hid=112ampsid=4e644f2b-9aba-4087-a654-

Figura 1 httpwwwgooglecomcoimgresimgurl=httpjamaama-assnorg

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