| Autor: |
Cridge, Harry, Little, Alison, Jose-Lopez, Roberto, Pancotto, Theresa, Michaels , Jennifer, Menchetti, Marika, Sunol Iniesta, Anna, Lipsitz, David, Beasley, Michaela |
| Jazyk: |
angličtina |
| Rok vydání: |
2021 |
| Předmět: |
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| Zdroj: |
Cridge, H, Little, A, Jose-Lopez, R, Pancotto, T, Michaels, J, Menchetti, M, Sunol Iniesta, A, Lipsitz, D & Beasley, M 2021, ' Neostigmine Challenge in the Diagnosis of Acquired Myasthenia Gravis ', Journal of Veterinary Emergency and Critical Care, vol. 31, no. 5, pp. 647-655 . https://doi.org/10.1111/vec.13097 |
| DOI: |
10.1111/vec.13097 |
| Popis: |
Objective: To assess the clinical utility of neostigmine methylsulphate administration in the diagnosis of suspected acquired myasthenia gravis (MG) in dogs and catsDesign: Retrospective study (2017-2019)Setting: Five university teaching hospitals and two private referral hospitalsAnimals: Twenty-two dogs and three cats. Criteria for inclusion were clinical signs consistent with acquired MG, performance of a neostigmine challenge and performance of acetylcholine receptor antibody titers. Interventions: Neostigmine methylsulphate administration via the subcutaneous, intramuscular or intravenous route. Anticholinergic premedication was performed at the discretion of the primary veterinarian. Measurements & Main Results: Response to neostigmine challenge was determined via sequential evaluation of muscle strength and ambulation after administration of neostigmine methylsulphate. Response to neostigmine challenge was compared to acetylcholine receptor antibody titers, which were used as the biochemical gold standard in this study. Sixteen out of 22 dogs were diagnosed with acquired MG. Thirteen of 16 had a strong positive response to neostigmine challenge whereas 3/16 had no response. Two out of 3 dogs with polymyositis also had a strong positive response to neostigmine challenge. Weak positive results were seen with intracranial neoplasia (n=1) and a dog with dilated cardiomyopathy and coxofemoral joint disease (n=1). One cat was diagnosed with acquired MG and had a positive response to neostigmine challenge. Two cats had no response to neostigmine challenge and were diagnosed with alternate conditions. Two cats were premedicated with glycopyrrolate, one of which had a mild adverse response to neostigmine challenge (sialorrhea and mild transient tremors). Three out of 22 dogs had minimal adverse effects (sialorrhea and one dog with muscle tremors).Conclusions: The neostigmine challenge is a safe and viable alternative to the previously utilized edrophonium challenge, particularly when weak positive responses are considered negative for acquired MG. Polymyositis cases may have a false positive response to neostigmine challenge. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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