scholarly journals Eculizumab during Pregnancy in a Patient with Treatment-Refractory Myasthenia Gravis: A Case Report

2021 ◽  
pp. 65-71
Author(s):  
Tuan Vu ◽  
Brittany Harvey ◽  
Niraja Suresh ◽  
Jerrica Farias ◽  
Clifton Gooch
Keyword(s):  
Case Report ◽  
Myasthenia Gravis ◽  
Potential Role ◽  
Treatment Options ◽  
Current Treatment ◽  
Humanized Monoclonal Antibody ◽  
Child Bearing ◽  
Positive Treatment ◽  
Treatment Refractory ◽  
Anti Acetylcholine

The recombinant humanized monoclonal antibody eculizumab has been shown to be effective and well tolerated in patients with anti-acetylcholine receptor antibody-positive, treatment-refractory generalized myasthenia gravis (gMG). Myasthenia gravis (MG) often affects women of child-bearing potential. However, management can be challenging during pregnancy, and current treatment options are limited due to potential teratogenicity. Data are currently lacking on the use of eculizumab in pregnant women with gMG. This case report describes a successful pregnancy in a young woman with treatment-refractory gMG treated with eculizumab before, during, and after pregnancy. Eculizumab appeared to have a favorable benefit-risk profile in this setting, with no treatment-related adverse effects noted in either the patient or the neonate. The patient remains neurologically stable on eculizumab, which she has now been receiving for 5 years. This first report of the use of eculizumab during pregnancy in a patient with treatment-refractory gMG suggests a potential role for eculizumab in this setting, although further clinical experience is necessary to support its use during pregnancy in women with MG.

Atypical Cogan's syndrome: A case report and summary of current treatment options

2015 ◽  
Vol 79 (3) ◽  
pp. 428-431 ◽  
Author(s):  
Debora Jančatová ◽  
Karol Zeleník ◽  
Pavel Komínek ◽  
Petr Matoušek
Keyword(s):  
Case Report ◽  
Treatment Options ◽  
Current Treatment ◽  
Cogan’S Syndrome ◽  
Cogan's Syndrome

Post-thymectomy myasthenia gravis: a case report and systematic review of literature

2021 ◽  
Vol 14 (12) ◽  
pp. e246005
Author(s):  
Louise Gurowich ◽  
Gabriel Yiin ◽  
Adam Maxwell ◽  
Alexandra Rice
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Myasthenia Gravis ◽  
Early Onset ◽  
Late Onset ◽  
High Morbidity ◽  
Review Of Literature ◽  
Prompt Treatment ◽  
Autoimmune Condition ◽  
Anti Acetylcholine

Myasthenia gravis (MG) is an autoimmune condition affecting the neuromuscular junction characterised by weakness and fatiguability, carrying a high morbidity if treatment is delayed. A clear association with thymoma has led to management with thymectomy as a common practice, but MG presenting post-thymectomy has rarely been reported. We present a case of an 82- year-old woman developing fatigue, ptosis and dysarthria 3 months after thymectomy. After a clinical diagnosis of MG was made, she responded well to prompt treatment with prednisolone and pyridostigmine. Her anti-acetylcholine receptor antibody (anti-AChR) subsequently came back positive. Our systematic review reveals that post-thymectomy MG can be categorised as early-onset or late-onset form with differing aetiology, and demonstrated correlation between preoperative anti-AChR titres and post-thymectomy MG. The postulated mechanisms for post-thymectomy MG centre around long-lasting peripheral autoantibodies. Clinicians should actively look for MG symptoms in thymoma patients and measure anti-AChR preoperatively to aid prognostication.

scholarly journals Acute Respiratory Distress due to Thymoma in a Patient Treated with TK Inhibitor: A Case Report and Review of the Current Treatment Options

2011 ◽  
Vol 4 (1) ◽  
pp. 155-161
Author(s):  
P. Zarogoulidis ◽  
D. Matthaios ◽  
A. Iordanidis ◽  
V. Zervas ◽  
A. Mitrakas ◽  
...  
Keyword(s):  
Case Report ◽  
Respiratory Distress ◽  
Treatment Options ◽  
Current Treatment

scholarly journals Frequency and clinical features of treatment-refractory myasthenia gravis

2019 ◽  
Vol 267 (4) ◽  
pp. 1004-1011 ◽  
Author(s):  
Jakob Rath ◽  
Ines Brunner ◽  
Matthias Tomschik ◽  
Gudrun Zulehner ◽  
Eva Hilger ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Clinical Features ◽  
Health Care Providers ◽  
Treatment Options ◽  
Unmet Need ◽  
Immunosuppressive Drugs ◽  
Care Providers ◽  
Class Iii ◽  
Treatment Refractory

Abstract Background To investigate the frequency and characterize the clinical features of treatment-refractory myasthenia gravis in an Austrian cohort. Methods Patient charts of 126 patients with generalized myasthenia gravis and onset between 2000 and 2016 were analyzed retrospectively. Patients were classified as treatment-refractory according to strict, predefined criteria. These mandated patients being at least moderately symptomatic (i.e., MGFA class III) or needing either maintenance immunoglobulins or plasma exchange therapy for at least 1 year in spite of two adequately dosed immunosuppressive drugs. Clinical features and outcome at last follow-up were compared to treatment-responsive patients. Results 14 out of 126 patients (11.1%) met these criteria of treatment-refractory myasthenia gravis. Treatment-refractory patients had more frequent clinical exacerbations and more often received rescue treatments or a further escalation of immunosuppressive therapies. They also remained more severely affected at last follow-up. An early onset of myasthenia gravis was associated with a higher risk for a refractory course. Conclusion A small subgroup of patients with generalized myasthenia gravis do not respond sufficiently to standard therapies. Refractory disease has considerable implications for both patients and health care providers and highlights an unmet need for new treatment options.

Pain Management Techniques for Loin Pain Hematuria Syndrome Case Report

2020 ◽  
pp. 141-144
Author(s):  
Sarang Koushik
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Spinal Cord Stimulation ◽  
Renal Denervation ◽  
Treatment Options ◽  
Disease Process ◽  
Current Treatment ◽  
Flank Pain ◽  
Loin Pain ◽  
Loin Pain Hematuria Syndrome

Background: Loin pain hematuria syndrome (LPHS) is a rare syndrome presenting with chronic unilateral or bilateral flank pain and gross or microscopic hematuria. Case Report: We present a case of LPHS in a male with past medical history of atrial fibrillation, Barrett’s esophagus, and loin pain hematuria syndrome who initially presented to our medical facility with gross hematuria, intractable left flank pain, and non-bloody emesis. Our case exemplifies the challenge in managing patients with LPHS. Conclusion: Without a definitive mechanism for LPHS, current treatment focuses on symptom management. Analgesics (non-opioid and opioid) may be used orally or intravenous depending on the presence of concomitant nausea and vomiting. For patients at risk of opioid dependence, targeting afferent pain fibers originating from the kidneys and ureters has proven a successful analgesic strategy. Surgical options for renal denervation include: endovascular radiofrequency ablation, laparoscopic renal denervation, and renal auto transplant. Treatment options for this disease process include intra-ureteric bupivacaine, renal denervation, and possible spinal cord stimulation. Key words: Flank pain, loin pain hematuria syndrome, renal denervation, spinal cord stimulation

scholarly journals Impact of SARS-CoV-2 Genetic Blueprints on the Oral Manifestation of COVID-19: A Case Report

2021 ◽  
Author(s):  
Amir Khodavirdipour ◽  
Mahsa Asadimanesh ◽  
Seyed Alireza Masoumi
Keyword(s):  
Case Report ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
Current Treatment ◽  
Oral Diseases ◽  
Angiotensin Converting Enzyme 2 ◽  
Oral Manifestation ◽  
Life Threatening ◽  
History Of ◽  
The Common

AbstractNonsegmented positive-sense RNA enveloped RNA severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus can result in coronavirus disease 2019 (COVID-19). This virus is from β-coronaviridae family of viruses. The common signs and symptoms of COVID-19 include pyrexia, cough, dyspnea, fatigue, myalgia, cephalgia, diarrhea, and nausea. Physicians and dentists around the world could directly link the COVID-19 and oral diseases such as ageusia and anosmia. After time passes, different aspects of symptoms of the diseases have been discovered. Research suggests that the oral cavity is the most vulnerable region for the virus because of angiotensin-converting enzyme-2 (ACE2) receptor abundance in the mouth. In this case report (no. of patients = 6), we would like to report significant findings in patients who were diagnosed with COVID-19 reported to our clinic during May 2021 complaining about the oral manifestation of it such as xerostomia, gingival inflammation, and cracked teeth. All patients are younger than 40 years with no history of dental complaints and oral diseases. Fortunately, these symptoms are not life threatening and treatable/manageable by current treatment options. To date, there is no clear proof of how and via which pathway, SARS-CoV-2 genomic blueprint causes the oral manifestation of COVID-19 beside ACE2 receptor which is the only known biopathway for such incidents.

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