When is there a full recovery for a myasthenia gravis patient?
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Summary
A myasthenia gravis (MG) patient who seems to have recovered can later have recurrence of myasthenic signs. Clearly clinical remission does not always correspond to the normalization of all the factors involved in the pathogenesis of the disease. In ten patients who had apparently recovered from MG, electromyographic tests of repetitive supramaximal stimulation were performed and the anti-acetylcholine receptor (anti-AChR) antibody was assessed. In two of the ten patients all these tests were normal, thus showing lack of electromyographic myasthenic fatigability and the absence of circulating anti-AChR antibodies. Our hypothesis is that for these two subjects the risk of a recurrence of MG is lower than for the others.
Key words
Myasthenia gravis Remission Recovery Electromyographic myasthenic fatigability Acetylcholine receptor Antiacetylcholine receptor antibodyZusammenfassung
Ein Patient mit Myasthenia gravis kann auch dann, wenn er sich anscheinend von der Erkrankung vollständig erholt hat, Rückfälle aufweisen. Es ist offensichtlich, daß eine klinische Remission durchaus nicht mit der Normalisierung aller beim Krankheitsprozeß mitwirkenden pathogenetischen Faktoren identisch ist. Bei 10 Patienten, die klinisch scheinbar geheilt waren, wurden elektromyographische Untersuchungen mit repetitiver supramaximaler Reizung ausgeführt sowie die Antiacethylcholinrezeptorenantikörper bestimmt. Zwei der 10 Patienten wiesen normale elektromyographische Befunde und das Fehlen zirkulierender Antiacethylcholinrezeptorenantikörper auf. Die Autoren formulieren die Annahme, daß für diese zwei Individuen das Rückfallrisiko niedriger als bei den anderen ist.
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References
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