Myasthenia gravis and risks for comorbidity
Identifieur interne : 000F39 ( Main/Exploration ); précédent : 000F38; suivant : 000F40Myasthenia gravis and risks for comorbidity
Auteurs : N. E. Gilhus [Norvège] ; A. Nacu [Norvège] ; J. B. Andersen [Norvège] ; J. F. Owe [Norvège]Source :
- European Journal of Neurology [ 1351-5101 ] ; 2015-01.
Abstract
Myasthenia gravis (MG) is an autoimmune disorder leading to skeletal muscle weakness and fatigability. MG subgroups are defined according to pathogenetic autoantibody (against acetylcholine receptor, muscle‐specific tyrosine kinase or lipoprotein receptor‐related protein 4), thymus pathology and clinical manifestations. MG patients have an increased risk for concordant autoimmune disease, in particular with early onset MG. Most common comorbidities are thyroid disease, systemic lupus erythematosus and rheumatoid arthritis. Cardiomyositis and subclinical heart dysfunction have been described in patients with thymoma MG and late onset MG but represent no major threat. A thymic lymphoepithelioma implies an increased risk for another cancer. Autoimmune MG represents no distinct cancer risk factor, although lymphomas and a few other cancer types have been reported with slightly increased frequency. Severe MG‐related muscle weakness means a risk for respiratory failure and respiratory tract infection. Drug MG treatment can lead to side‐effects. Thymectomy is regarded as a safe procedure both short and long term. Non‐MG‐related comorbidity represents a diagnostic and therapeutic challenge, especially in elderly patients. Diagnostic accuracy and optimal follow‐up is necessary to identify and treat all types of coexisting disease in MG.
Url:
DOI: 10.1111/ene.12599
Affiliations:
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MG subgroups are defined according to pathogenetic autoantibody (against acetylcholine receptor, muscle‐specific tyrosine kinase or lipoprotein receptor‐related protein 4), thymus pathology and clinical manifestations. MG patients have an increased risk for concordant autoimmune disease, in particular with early onset MG. Most common comorbidities are thyroid disease, systemic lupus erythematosus and rheumatoid arthritis. Cardiomyositis and subclinical heart dysfunction have been described in patients with thymoma MG and late onset MG but represent no major threat. A thymic lymphoepithelioma implies an increased risk for another cancer. Autoimmune MG represents no distinct cancer risk factor, although lymphomas and a few other cancer types have been reported with slightly increased frequency. Severe MG‐related muscle weakness means a risk for respiratory failure and respiratory tract infection. Drug MG treatment can lead to side‐effects. Thymectomy is regarded as a safe procedure both short and long term. Non‐MG‐related comorbidity represents a diagnostic and therapeutic challenge, especially in elderly patients. Diagnostic accuracy and optimal follow‐up is necessary to identify and treat all types of coexisting disease in MG.</div></front></TEI><affiliations><list><country><li>Norvège</li></country></list><tree><country name="Norvège"><noRegion><name sortKey="Gilhus, N E" sort="Gilhus, N E" uniqKey="Gilhus N" first="N. E." last="Gilhus">N. E. Gilhus</name></noRegion><name sortKey="Andersen, J B" sort="Andersen, J B" uniqKey="Andersen J" first="J. B." last="Andersen">J. B. Andersen</name><name sortKey="Gilhus, N E" sort="Gilhus, N E" uniqKey="Gilhus N" first="N. E." last="Gilhus">N. E. Gilhus</name><name sortKey="Gilhus, N E" sort="Gilhus, N E" uniqKey="Gilhus N" first="N. E." last="Gilhus">N. E. Gilhus</name><name sortKey="Nacu, A" sort="Nacu, A" uniqKey="Nacu A" first="A." last="Nacu">A. Nacu</name><name sortKey="Nacu, A" sort="Nacu, A" uniqKey="Nacu A" first="A." last="Nacu">A. Nacu</name><name sortKey="Owe, J F" sort="Owe, J F" uniqKey="Owe J" first="J. F." last="Owe">J. F. Owe</name><name sortKey="Owe, J F" sort="Owe, J F" uniqKey="Owe J" first="J. F." last="Owe">J. F. Owe</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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