Italian recommendations for the diagnosis and treatment of myasthenia gravis
| Autor: | Antonio DiMuzio, Maurizio Inghilleri, Carlo Antozzi, Cesare Iani, Renato Mantegazza, Amelia Evoli, Elena Pegoraro, Rocco Liguori, Carmelo Rodolico, Roberta Ricciardi, Giovanni Antonini, Francesco Habetswallner, Roberto Massa |
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| Přispěvatelé: | Evoli, Amelia, Antonini, Giovanni, Antozzi, Carlo, DiMuzio, Antonio, Habetswallner, Francesco, Iani, Cesare, Inghilleri, Maurizio, Liguori, Rocco, Mantegazza, Renato, Massa, Roberto, Pegoraro, Elena, Ricciardi, Roberta, Rodolico, Carmelo |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Weakness medicine.medical_treatment Immunosuppressive therapy Myasthenia gravis Plasma exchange Rituximab Thymectomy Female Humans Italy Myasthenia Gravis Practice Guidelines as Topic Patient characteristics Myasthenia gravi Dermatology Disease Settore MED/26 03 medical and health sciences 0302 clinical medicine myasthenia gravis thymectomy plasma exchange rituximab medicine 030212 general & internal medicine Intensive care medicine Adverse effect Radiation treatment planning business.industry Immunosuppression General Medicine medicine.disease Settore MED/26 - NEUROLOGIA Specific antibody Psychiatry and Mental Health 2708 Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 40(6) |
| ISSN: | 1590-3478 |
| Popis: | Myasthenia gravis is a well-treatable disease, in which a prompt diagnosis and an adequate management can achieve satisfactory control of symptoms in the great majority of patients. Improved knowledge of the disease pathogenesis has led to recognition of patient subgroups, according to associated antibodies, age at onset and thymus pathology, and to a more personalized treatment. When myasthenia gravis is suspected on clinical grounds, diagnostic confirmation relies mainly on the detection of specific antibodies. Neurophysiological studies and, to a lesser extent, clinical response to cholinesterase inhibitors support the diagnosis in seronegative patients. In these cases, the differentiation from congenital myasthenia can be challenging. Treatment planning must consider weakness extension and severity, disease subtype, thymus pathology, together with patient characteristics and comorbidities. Since most subjects with myasthenia gravis require long-term immunosuppressive therapy, surveillance of expected and potential adverse events is critical. For patients refractory to conventional immunosuppression, the use of biologic agents is highly promising. These recommendations are addressed to non-experts on neuromuscular transmission disorders. The diagnostic procedures and therapeutic approaches hereafter described are largely accessible in Italy. |
| Databáze: | OpenAIRE |
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