Diagnosis and therapeutic techniques used for the management of myasthenia gravis

Authors

Keywords:

Autoimmune Diseases, Myasthenia Gravis, Receptors, Cholinergic, Diagnostic Techniques, Neurological, Therapeutic

Abstract

Myasthenia gravis is an autoimmune disorder of neuromuscular transmission characterized by the production of autoantibodies directed mainly at cholinergic receptors. It affects the voluntary muscles, producing fatigue and fluctuating weakness. Its prevalence has increased given the improvement in the diagnosis of the disease. Due to the similarity of symptoms with other disorders and the therapeutic behaviors available, the authors set out to characterize the most current diagnostic and therapeutic techniques used for the management of myasthenia gravis. The diagnostic is fundamentally clinical; it relies on bedside exploratory, serological, electrophysiological, imaging and pulmonary function techniques, which allow its confirmation and orientation of the most effective therapeutic line for each patient. Although there is no cure, the prognosis of the disease is good. Current therapy includes symptomatic and surgical treatment through thymectomy (the most effective), as well as immunosuppressive, short-term immunomodulatory and supportive techniques.

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Author Biography

Mónica de la Caridad Reyes-Tápanes, Universidad de Ciencias Médicas de Matanzas

Alumna Ayudante de Neurología

References

Gilhus NE, Tzartos S, Evoli A, Palace J, Burns TM, Verschuuren JJGM. Myasthenia Gravis. Nat Rev Dis Primers [Internet]. 2019 [citado 2020 Sep 18]; 5(30). Disponible en: https://doi.org/10.1038/s41572-019-0079-y

Rubin M. Miastenia Grave. [Internet].Manuales Msd; 2018 [citado 2020 Oct 15]. Disponible en: https://www.merckmanuals.com/es-us/hogar/enfermedades-cerebrales,-medulares-y-nerviosas/trastornos-de-los-nervios-periféricos/miastenia-grave

Manual Práctico Día a Día de la Miastenia. [Internet]. Asociación Miastenia de España, 2019 [citado 2020 Oct 15]. Disponible en: https://miastenia.ong/wp-content/uploads/2019/01/MANUAL-PRÁCTICO-AMES.pdf

González R, Riquelme A, Fuentealba M, Canale J, Fuentes A, Saldías R, et al. Miastenia gravis: resultados inmediatos y alejados de la timectomía transesternal extendida. Rev Med Chile [Internet]. 2018 [citado 2020 Oct 15]; 146:460-469. Disponible en: https://scielo.conicyt.cl/pdf/rmc/v146n4/0034-9887-rmc-146-04-0460.pdf

Herrera Lorenzo O, Infante Ferrer J, Casares Albernas F. Miastenia Gravis: diagnóstico y tratamiento. AMC [Internet]. 2009 Oct [citado 2020 Oct 24]; 13(5):0-0. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1025-02552009000500014&lng=es.

Pérez-Nellar J, Rodríguez A. Falsos negativos en el diagnóstico de la miastenia gravis. Rev Neurol [Internet]. 2000 [citado 2020 Sep 13]; 30(08): 712-715. Disponible en: https://doi.org/10.33588/rn.3008.99532

Pérez-Nellar J. Diagnóstico y tratamiento de la miastenia gravis en el Hospital Hermanos Ameijeiras [Internet]. docplayer 2004 [citado 2020 Oct 23]. Disponible en: https://docplayer.es/73435299-Diagnostico-y-tratamiento-de-la-miastenia-gravis-en-el-hospital-hermanos-ameijeiras.html

Martínez Torre S, Gómez Molinero I. Puesta al día en la miastenia gravis. Medicina de familia SEMERGEN [Internet]. 2018 [citado 2020 Sep 18]; 44(5):351-354. Disponible en: https://doi.org/10.1016/j.semerg.2018.01.003

Cisneros-Linares A, Luis-González S, León-González RA, Carrera PL. Algunos aspectos epidemiológicos de la miastenia gravis en Cuba. Rev Neurol [Internet]. 1996 [citado 2020 Sep 18]; 24(128):435-439. Disponible en: https://doi.org/10.33588/rn.24128.96595

Aguirre F, Villa AM. Miastenia Gravis. Registro de 190 casos en un centro único. Medicina (B Aires) [Internet]. 2020 [citado 2020 Oct 14]; 80(1):10-16. Disponible en: https://www.medicinabuenosaires.com/indices-de-2020/volumen-80-ano-2020-no-1-indice/miastenia/

Turbert D. ¿Qué es la miastenia gravis? [Internet]. American Academy of Ophthalmology. 2020 Abr 21 [citado 2020 Sep 15]. Disponible en: https://www.aao.org/salud-ocular/enfermedades/miastenia-gravis

Bravo-Loor GH. Factores de riesgo en miastenia gravis. [Tesis de Maestría] Guayaquil; Universidad de Guayaquil. Facultad de Ciencias Médicas; 2019 [citado 2020 Oct 23]. Disponible en: http://repositorio.ug.edu.ec/handle/redug/43225.

Binks S, Vicent A, Palace J. Myasthenia gravis: a clinical-immunological update. J Neurol [Internet]. 2016 Apr [citado 2020 Oct 23]; 263 (4): 826-34. Disponible en https://doi.org/10.1007/s00415-015-7963-5.

Drachman DB, Amato AA. Myasthenia gravis and other diseases of the neuromuscular junction. En: Braunwald E, Hauser S, Fauci A, Longo D, Kasper D, Jameson JL. Harrison's Principles of Internal Medicine. 15 ed. New York: McGraw-Hill; 2001. p. 15-20.

Hughes T. The early history of myasthenia gravis. Neuromuscul Disord. [Internet]. 2005 [citado 2020 Oct 25]; 15(12):878-86. Disponible en: https://doi.org/10.1016/j.nmd.2005.08.007

Khalid R, Ibad A, Thompson PD. Las estatinas y la miastenia grave. Muscle Nerve [Internet]. 2016 [citado 2020 Oct 25]; 54:509. Disponible en: http://dx.doi.org/10.1002/mus.25155

Natarajan B, Saifudheen K, Gafoor VA, Jose J. Accuracy of the ice test in the diagnosis of myasthenic ptosis. Neurol India. [Internet]. 2016 [citado 2020 Oct 25]; 64(6):1169-72. Disponible en: https://www.neurologyindia.com/text.asp?2016/64/6/1169/193780

Nicolle MW. Myasthenia Gravis and Lambert-Eaton Myasthenic Syndrome. Contin Minneap Minn. [Internet]. 2016 [citado 2020 Oct 25]; 22(6):1978-2005. Disponible en: https://journals.lww.com/continuum/Fulltext/2016/12000/Myasthenia_Gravis_and_Lambert_Eaton_Myasthenic.16.aspx

Robalino-Vaca JG. Miastenia gravis. Tesis para obtención del grado académico de médico general. Escuela Superior Politécnica de Chimborazo. Riobamba. [Internet].2018 Jun [citado 2020 Oct 25]; [aprox. 34 p.]. Disponible en: http://dspace.espoch.edu.ec/handle/123456789/8595

Jordan B, Kellner J, Jordan K, Bähre M, Behrmann C, Zierz S. Thymic pathologies in myasthenia gravis: a preoperative assessment of CAT scan and nuclear based imaging. J Neurol. [Internet]. 2016 [citado 2020 Oct 25]; 263(4):641-8. Disponible en: https://doi.org/10.1007/s00415-016-8023-5

Castro-Suárez S, Caparó-Zamalloa C, Meza-Vega M. Actualización en Miastenia gravis. Rev Neuro-Psiquiatría [Internet]. 2017 [citado 2020 Oct 25]; 80(4): 247-260. Disponible en: https://doi.org/10.20453/rnp.v80i4.3239

Sussman J, Farrugia ME, Maddison P, Hill M, Leite MI, Hilton-Jones D. Myasthenia gravis: Association of British Neurologists’ management guidelines. Practical Neurology [Internet]. 2015 [citado 2020 Oct 25]; 15(3): 199-206. Disponible en: https://doi.org/10.1136/practneurol-2015-001126.

Romi F, Hong Y, Gilhus NE. Pathophysiology and immunological profile of myasthenia gravis and its subgroups. Curr Opin Immunol [Internet]. 2017 [citado 2020 Oct 25]; 49: 9-13. Disponible en: https://europepmc.org/article/med/28780294

Li ZY. China guidelines for the diagnosis and treatment of myasthenia gravis. Neuroimmunol Neuroinflammation [Internet]. 2016 [citado 2020 Oct 25]; 3(1):1. Disponible en: https://doi.org/10.20517/2347-8659.2015.60

Sander DB, Wolfe GI, Benatar M, Evoli A, Gilhusss NE, Illa I, et al. Orientación consenso internacional para la gestión de la miastenia gravis. Neurología [Internet]. 2016 [citado 2020 Oct 25]; 87(4):419-25. Disponible en: https://doi.org/10.1212/WNL.0000000000002790

Aydin Y, Ulas AB, Mutlu V, Colak A, Eroglu A. Thymectomy in Myasthenia Gravis. Eurasian J Med. [Internet]. 2017 [citado 2020 Oct 25]; 49(1):48-52. Disponible en: https://doi.org/10.5152/eurasianjmed.2017.17009

Diagnóstico y tratamiento de Miastenia Gravis. Guía de Práctica Clínica: Evidencias y Recomendaciones [Internet]. México, CENETEC; 2020 [citado 2020 Oct 25]. Disponible en: http://www.cenetec-difusion.com/CMGPC/GPC-institucion-num-año/ER.pdf

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Published

2022-05-22

How to Cite

1.
Barceló-Vázquez Y, Reyes-Tápanes M de la C, Ojito-Valdés I. Diagnosis and therapeutic techniques used for the management of myasthenia gravis. MedEst [Internet]. 2022 May 22 [cited 2024 Nov. 7];2(1):e28. Available from: https://revmedest.sld.cu/index.php/medest/article/view/28

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Vol. 2 No. 1 (2022)

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REVIEW ARTICLES

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