Nonresponsiveness to anticholinesterase agents in patients with MuSK-antibody-positive MG
2005; Lippincott Williams & Wilkins; Volume: 65; Issue: 9 Linguagem: Inglês
10.1212/01.wnl.0000183145.91579.74
ISSN1526-632X
AutoresYuki Hatanaka, Shoji Hemmi, Marla B. Morgan, Mia L. Scheufele, Gwen C. Claussen, Gil I. Wolfe, Shin J. Oh,
Tópico(s)Antifungal resistance and susceptibility
ResumoPatients with seronegative myasthenia gravis (MG) often harbor antibodies for muscle-specific tyrosine kinase (MuSK).1 Nonresponsiveness or poor tolerability of anticholinesterase therapy has been mentioned in reports of this population2,3 but not comprehensively studied. We report anticholinesterase nonresponsiveness in 14 MuSK-antibody (Ab) positive patients seen at the University of Alabama at Birmingham (UAB) and University of Texas Southwestern Medical Center (UTSW), comparing them to MuSK-Ab-negative and acetylcholine receptor (AChR)-Ab seropositive patients from the UAB. Anticholinesterase hypersensitivity was defined when myasthenic symptoms worsened with medication; anticholinesterase intolerance when the patient developed severe cholinergic side effects with small doses of pyridostigmine or edrophonium, even with the administration of atropine or glycopyrrolate; and no improvement when there was no clinical benefit following administration of pyridostigmine. Hypersensitivity, intolerance, and no improvement were grouped together as anticholinesterase nonresponsiveness. At UAB, the AChR-Ab test was positive in 73 (72%) of 102 patients with generalized MG; the MuSK antibody test was positive in 7 (24%) of the …
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