- |||||||||| Enrollment open, Trial completion date, Trial initiation date, Trial primary completion date: VRMG: Vitaccess Real MG Registry (clinicaltrials.gov) - Aug 6, 2024
P=N/A, N=600, Recruiting,
Not yet recruiting --> Recruiting | Trial completion date: Mar 2034 --> Jul 2034 | Initiation date: Mar 2024 --> Jul 2024 | Trial primary completion date: Mar 2034 --> Jul 2034
- |||||||||| Anesthetic Considerations in Congenital Myasthenic Syndrome (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_5079;
This medically challenging case suggests that patients with congenital myasthenic syndrome demonstrate a sensitivity to non-depolarizing neuromuscular blocking drugs. Neuraxial analgesia with caudal administration of dilute local anesthetics appears to be safe.
- |||||||||| Management of Intra-Operative Iatrogenic Aortic Perforation (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_4297;
Immediate mobilization of vascular and trauma teams facilitated urgent aortic repair. Hemodynamic stability was restored through arterial and central line placement, high-dose vasopressors, and a massive transfusion protocol, underscoring the critical need for rapid interdisciplinary response in surgical emergencies.
- |||||||||| fentanyl citrate / Generic mfg., remifentanil / Generic mfg., dexmedetomidine / Generic mfg.
Anesthetic Management of a Patient with Multiple Comorbid Neuromuscular Disorders (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_3999;
Given her comorbidities and prior perioperative complications, we instead proposed to pursue conscious sedation with a bolus of remifentanil for analgesia during the brief period of painful stimulus. She tolerated the procedure well with a combination of propofol, fentanyl, and dexmedetomidine and recovered appropriately.
- |||||||||| PACU Puzzle: A New Diagnosis of Myasthenia Gravis (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_3707;
During recovery in the post-anesthesia care unit (PACU), the patient exhibited new onset dysarthria and days later was diagnosed with myasthenia gravis. This case report aims to detail the presentation of new onset myasthenia gravis in the PACU following general anesthesia and detail the anesthetic considerations that must be made for patients diagnosed with the disease.
- |||||||||| azathioprine / Generic mfg.
Tattoo-related molluscum contagiosum (Poster Area) - Aug 5, 2024 - Abstract #EADV2024EADV_3956;
It presents with multiple firm flesh to white colored umbilicated papules. Tattoo-related molluscum contagiosum infection may be related to contamination by the needle, ink or artist
- |||||||||| prednisone / Generic mfg., azathioprine / Generic mfg.
Thymoma, a Nexus of Autoimmunity: A Rare Association with Systemic Lupus Erythematosus (Poster Area) - Aug 5, 2024 - Abstract #EADV2024EADV_2595;
Clinical manifestations of lupus in these cases are often nonspecific except for a median age of onset 48 years, and sex ratio, 4:3 (Female-Male) . The clinical outcome of the lupus does not appear to be influenced by the thymectomy.
- |||||||||| Journal: Clinical features of thymoma with and without myasthenia gravis. (Pubmed Central) - Aug 2, 2024
The prognosis of thymoma with MG is similar to that of thymoma alone. The main causes of death may be myasthenia crisis in thymoma patients with MG and advanced tumor stage in patients with thymoma alone.
- |||||||||| Review, Journal: Therapeutic Approach to Autoimmune Neurologic Disorders. (Pubmed Central) - Aug 1, 2024
Recognizing patients who have a clinical history and examination findings concerning for autoimmune neurologic disorders and conducting a thorough and directed imaging and laboratory evaluation aimed at ruling out mimics, identifying specific autoimmune syndromes, and screening for factors that may have an impact on immunotherapy choices early in the clinical course are essential to providing optimal care for these patients. Providers must consider immunotherapy, symptomatic treatment, and a multidisciplinary approach that addresses each patient's unique needs when treating patients with autoimmune neurologic disorders.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD), Vyvgart (efgartigimod alfa-fcab) / argenx, Broteio
IMMUNE CHECKPOINT INHIBITOR-RELATED MYASTHENIA GRAVIS, MYOSITIS, HEPATITIS, AND MYOCARDITIS (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5578;
ICI therapy can cause a spectrum of adverse autoimmune effects. Treatment for cases requiring intensive care includes holding ICI therapy at least temporarily, high-dose corticosteroids, and plasmapheresis or IVIG if symptoms are rapidly progressive or refractory.
- |||||||||| Rituxan (rituximab) / Roche, Zavicefta (ceftazidime/avibactam) / Pfizer, AbbVie
BALANCING TREATMENTS: A DIFFICULT AIRWAY WITH MYASTHENIA GRAVIS-ACQUIRED HEMOPHILIA AND PNEUMONIA (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5299;
Rare diseases like MG and AHA require active collaborations and integrations between different specialists, including critical care, neurology, and hematology for optimal outcomes. This case demonstrates a complex example of when ICU treatments may conflict, and emphasizes the importance of multidisciplinary collaborations.
- |||||||||| RESPIRATORY MYSTERIES: UNRAVELING A RARE NEUROMUSCULAR DISORDER THROUGH CARDIOPULMONARY EXERCISE TESTING (Convention Center 258 A) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4903;
Because early symptoms can be vague and non-specific, comprehensive testing such as that provided by CPET can identify early physiologic limitations, permitting earlier recognition of disease. Further research is warranted to explore the broader applicability of CPET in diagnosing and managing NMDs, trending progression of disease, potentially predicting patient outcomes and helping to manage disease expectations.
- |||||||||| CHRONIC PROGRESSIVE EXTERNAL OPHTHALMOPLEGIA: A CASE SERIES (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3863;
There are three modes of transmission- maternal transmission associated with mitochondrial point mutations, autosomal recessive, and autosomal dominant. CPEO can sometimes be difficult to diagnose especially in asymmetric presentation, therefore it is crucial to keep it in differential diagnosis to avoid delay in diagnosis.
- |||||||||| UNEXPECTED TERMINATION OF A CENTRAL VENOUS CATHETER: A CASE REPORT (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2960;
PLSVC is an often benign and clinically irrelevant anatomic variant. It can cause initial confusion during central venous device placement, and appropriate testing to ensure the device is in the venous system should be performed as evidenced in our case.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
TREATMENT OR TRIGGER? IMMUNE CHECKPOINT INHIBITOR-INDUCED MYASTHENIA GRAVIS IN A PATIENT WITH METASTATIC LUNG ADENOCARCINOMA (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2633;
CASE PRESENTATION: A 79 year old male with stage IV adenocarcinoma of the lung receiving ICI therapy with pembrolizumab (three cycles given, last seven days prior) presented with three days of hypophonia and increased oral secretions... As the indications for ICI therapy continue to grow, clinicians will need to be more familiar with the various irAEs these medications may cause, particularly those associated with high morbidity and mortality, like ICI related myasthenia gravis.
- |||||||||| Orencia (abatacept) / BMS, Keytruda (pembrolizumab) / Merck (MSD)
IMMUNE CHECKPOINT INHIBITOR INDUCED SEVERE OVERLAP SYNDROME: A CASE REPORT (Convention Center 256) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1883;
Understanding and recognizing the spectrum of complications linked to ICI therapy is vital for improving treatment outcomes. With increasing use of ICIs, further research is necessary to uncover the underlying pathophysiology, identify early biomarkers, and develop personalized interventions to enhance outcomes in patients with ICI-related overlap syndromes.
- |||||||||| morphine sulphate / Generic mfg.
LATE ONSET POSTPOLIO SYNDROME (PPS) WITH RECURRENT RESPIRATORY FAILURE AND SEVERE DYSPHAGIA: A CASE REPORT (Convention Center 258 B) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1847;
After receiving morphine for abdominal pain, she became obtunded and hypercarbic (pH 6.97, PCO2 >125 mmHg, PO2 199 mmHg, bicarbonate 37 mEq/L), requiring intubation... We report an 80-year-old woman with a late and severe onset of PPS, emphasizing the importance of vigilance in recognizing and managing respiratory and bulbar complications in poliomyelitis survivors.
- |||||||||| BEYOND WEAKNESS: UNRAVELING MYASTHENIA GRAVIS MENACING PATH: DYSPHAGIA, CHOKING, AND PERIL OF CARDIAC ARREST (Convention Center 258 B) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1845;
We report an 80-year-old woman with a late and severe onset of PPS, emphasizing the importance of vigilance in recognizing and managing respiratory and bulbar complications in poliomyelitis survivors. Clinicians should have MG as a differential diagnosis even in older patients, as well as those who present with dysphagia with no clear explanation.
- |||||||||| Soliris (eculizumab) / AstraZeneca, Vyvgart (efgartigimod alfa-fcab) / argenx, Broteio, Rituxan (rituximab) / Roche
REFRACTORY SEROPOSITIVE NONTHYMOMATOUS MYASTHENIA GRAVIS IN MYASTHENIC CRISIS: A CASE REPORT (Convention Center Exhibit Hall: Poster Area 4) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1706;
Refractory seropositive non-thymomatous MG represents a significant management challenge, requiring innovative treatment approaches beyond current standard care. This case underscores the importance of personalized treatment strategies and the need for continued research into effective therapies for refractory MG.
- |||||||||| A LARGE THYMIC TUMOR PRESENTING AS A RIGHT LUNG MASS (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1505;
Early-stage thymoma is confined within the capsule, with transcapsular invasion an adverse prognostic marker. Due to the risk of late local recurrence, long-term follow-up is appropriate.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
ANTI-OJ AUTOANTIBODIES AS AN EXACERBATING FACTOR IN PEMBROLIZUMAB-RELATED INTERSTITIAL LUNG DISEASE (ILD) (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1471;
CASE PRESENTATION: Our patient is a sixty-five year old male with history of pulmonary sarcoidosis, chronic hypoxic respiratory failure on three liters supplemental oxygen, obstructive sleep apnea on continuous positive airway pressure and stage IV NSCLC status post chemotherapy and immune therapy with Cisplatin, Pemetrexed and Pembrolizumab (PD-L1 humanized antibody) who presented with dyspnea and admitted for acute on chronic hypoxic respiratory failure within 1 month of Pembrolizumab initiation. We hypothesize that our patient rapidly developed new ILD due to the compounding effects of ICI pneumonitis and predisposition from anti-OJ autoantibodies.
- |||||||||| Tecentriq (atezolizumab) / Roche
Journal, PD(L)-1 Biomarker, IO biomarker: A Case of Liver Cancer with Overlapping Myasthenia Gravis, Myocarditis, Seronegative Autoimmune Autonomic Ganglionopathy, and Myositis Symptoms Induced by Atezolizumab: A Case Report. (Pubmed Central) - Jul 31, 2024
After immunotherapy, the serum markers and blood pressure normalized, and he was weaned from the ventilator after five months. To our knowledge, this is the first reported case of AAG secondary to ICI-induced myositis, MG, and myocarditis.
- |||||||||| Biomarker, Trial completion date, Trial primary completion date: Predictors and Prognostic Factors of Myasthenia Gravis Outcome (clinicaltrials.gov) - Jul 30, 2024
P=N/A, N=30, Recruiting,
To our knowledge, this is the first reported case of AAG secondary to ICI-induced myositis, MG, and myocarditis. Trial completion date: Aug 2024 --> Mar 2025 | Trial primary completion date: Jun 2024 --> Dec 2024
- |||||||||| Journal: Missense variants in CMS22 patients reveal that PREPL has both enzymatic and non-enzymatic functions. (Pubmed Central) - Jul 30, 2024
The importance of non-hydrolytic functions of PREPL was investigated in catalytically inactive PREPL p.Ser559Ala cell lines which showed that hydrolytic activity of PREPL is needed for normal mitochondrial function but not for regulating AP1-mediated transport in the trans-Golgi network. In conclusion, these studies showed that CMS22 can be caused not only by deletion and truncation of PREPL but also by missense variants that do not necessarily result in a loss of hydrolytic activity of PREPL.
- |||||||||| Olumiant (baricitinib) / Eli Lilly
Journal: Baricitinib as a treatment for myasthenia gravis: A case report. (Pubmed Central) - Jul 28, 2024
Furthermore, the titer of the anti-acetylcholine receptor antibody was decreased. This report represents the first reported case of anti-acetylcholine receptor antibody-positive MG that was successfully treated through the inhibition of JAK activity.
- |||||||||| AZD0120 / AstraZeneca
Trial completion date, Trial initiation date, Trial primary completion date: An Exploratory Clinical Study of GC012F Injection for Refractory gMG (clinicaltrials.gov) - Jul 28, 2024
P1, N=18, Not yet recruiting,
This report represents the first reported case of anti-acetylcholine receptor antibody-positive MG that was successfully treated through the inhibition of JAK activity. Trial completion date: Oct 2026 --> Oct 2027 | Initiation date: Jun 2024 --> Dec 2024 | Trial primary completion date: Jun 2026 --> Jun 2027
- |||||||||| Journal: Reliability and validity of cough peak flow measurements in myasthenia gravis. (Pubmed Central) - Jul 28, 2024
The CPF for identifying the aspiration risk was used to calculate the CPF cut-off value of 205 L/min with a sensitivity of 0.77, specificity of 0.90, and AUC of 0.85. The CPF, a convenient measure by patients themselves, has a high reliability in patients with MG, and is a useful biomarker reflecting MG symptoms.
|
