Myasthenia Gravis
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  • ||||||||||  [VIRTUAL] KERNEL OF TRUTH: AN INTERESTING CASE OF FOREIGN BODY ASPIRATION () -  Oct 12, 2020 - Abstract #CHEST2020CHEST_2568;    
    Due to the predisposition for a delayed diagnosis of FBA in the healthy adult population, a high index of suspicion and thorough history taking is warranted when dealing with cases of chronic cough and recurrent pneumonia to avoid long term sequelae.
  • ||||||||||  [VIRTUAL] DON’T JUDGE A BOOK BY ITS COVER: UNUSUAL CASE OF MYASTHENIA GRAVIS () -  Oct 12, 2020 - Abstract #CHEST2020CHEST_2351;    
    Due to the predisposition for a delayed diagnosis of FBA in the healthy adult population, a high index of suspicion and thorough history taking is warranted when dealing with cases of chronic cough and recurrent pneumonia to avoid long term sequelae. This case stresses the need for thorough evaluation for all patients with unexplained progressive dyspnea.
  • ||||||||||  [VIRTUAL] RARE CASE OF ADENOCARCINOMA OF THE LUNG PRESENTED AS LAMBERT-EATON MYASTHENIC SYNDROME () -  Oct 12, 2020 - Abstract #CHEST2020CHEST_2006;    
    It is vital to have a comprehensive approach in patients with proximal muscle weakness and autoimmune etiologies should be considered. Historically linked to SCLC,LEMS could be very rarely part of clinical presentation of adenocarcinoma of the lung, especially in smokers.Once LEMS is suspected, screening for malignancy is strongly advised and early pathohistologic detection of the cancer and appropriate therapy is vital.
  • ||||||||||  Botox (onabotulinumtoxin A) / GSK, AbbVie
    [VIRTUAL] IATROGENIC BOTULISM () -  Oct 12, 2020 - Abstract #CHEST2020CHEST_1514;    
    The patient was administered the Botulism Antitoxin Heptavalent antibody (BAT). Patients with compromised respiratory status treated with BOTOX injections for spasticity should be monitored closely.
  • ||||||||||  Opdivo (nivolumab) / Ono Pharma, BMS
    [VIRTUAL] ACUTE RESPIRATORY FAILURE SECONDARY NIVOLUMAB MYOSITIS () -  Oct 12, 2020 - Abstract #CHEST2020CHEST_1504;    
    Patient was started on solumedrol 100 mg IV with subsequent prednisone taper over 4 weeks. As the use of checkpoint inhibitors spreads, pulmonologist and intensives should become familiar with pulmonary and systemic manifestations.
  • ||||||||||  methimazole / Generic mfg., hydrocortisone / Generic mfg., amiodarone / Generic mfg.
    [VIRTUAL] A CALAMITOUS JUNCTION: NEUROMUSCULAR RESPIRATORY FAILURE FROM CONCOMITANT THYROTOXICOSIS AND MYASTHENIA GRAVIS () -  Oct 12, 2020 - Abstract #CHEST2020CHEST_1496;    
    Here we describe a case of severe amiodarone-induced thyrotoxicosis and MG which ultimately led to respiratory failure.CASE PRESENTATION: A 69-year-old female with atrial fibrillation treated with amiodarone presented to the hospital with 2 weeks of diarrhea, palpitations, weakness and dysphagia...Per Endocrinology recommendations, she received beta blockers, methimazole, Lugol’s iodine, and hydrocortisone... Our case demonstrates the overlapping neuromuscular features of hyperthyroidism and myasthenia gravis, of which respiratory failure may be a fatal, common final pathway.
  • ||||||||||  Neupogen (filgrastim) / Kyowa Hakko Kirin, Roche, Amgen
    [VIRTUAL] A CASE OF MYASTHENIA GRAVIS ASSOCIATED WITH APLASTIC ANEMIA () -  Oct 12, 2020 - Abstract #CHEST2020CHEST_1328;    
    To the best of our knowledge, this is the first report of a patient with concomitant primary hyperparathyroidism, myasthenia gravis (MG), and aplastic anemia (AA). This case raises awareness of this rare association in order to recognize patients who have this constellation of clinical presentations.
  • ||||||||||  Actemra IV (tocilizumab) / Roche, JW Pharma
    [VIRTUAL] CORONAVIRUS DISEASE 2019 AND CAVEATS OF IMMUNOMODULATORS () -  Oct 12, 2020 - Abstract #CHEST2020CHEST_1157;    
    It was also thought that his diaphragm hemiparesis was possibly exacerbated by a myasthenic crisis in the setting of a viral illness and recent use of azithromycin...He was treated with hydroxychloroquine, tocilizumab, pyridostigmine, steroids and IVIG... COVID-19 must not preclude the use of immunomodulatory therapies such as steroids and IVIG if indicated for a comorbid condition and given the hyper-inflammatory state of this disease, immunomodulatory therapies deserve consideration for the treatment of COVID-19.
  • ||||||||||  Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
    [VIRTUAL] Membranous Nephropathy Preceding the Recurrence of Thymoma (On-Demand) -  Oct 11, 2020 - Abstract #KIDNEYWEEK2020KIDNEY_WEEK_2132;    
    In February 2020, he presented with worsening anasarca and a myasthenic flare, for which he was treated with steroids, five sessions of plasma exchange and rituximab...In this study the PET imaging group identified 5 cases of malignancy among 49 patients, while the conventional screening only identified 1 case of malignancy among 75 patients. While PET imaging may be the optimal imaging for undiagnosed malignancy or recurrent malignancy in patients with newly diagnosed membranous nephropathy, this case presentation suggests that thymoma recurrence with nephrotic syndrome may precede a positive result on PET imaging.
  • ||||||||||  Review, Journal:  Anti-SOX1 Antibodies in Paraneoplastic Neurological Syndrome. (Pubmed Central) -  Oct 9, 2020   
    In conclusion, the presence of anti-SOX1 abs alone is a potential predictor of an uncommon paraneoplastic neurological disorder, usually occurring in the setting of LEMS, PCD, and SCLC. The detection of anti-SOX1 abs contributes to an early diagnosis of underlying tumors, given the diversity of clinical symptoms and the absence of characteristic neuroimaging features.
  • ||||||||||  Clinical, Review, Journal:  The Structure, Function, and Physiology of the Fetal and Adult Acetylcholine Receptor in Muscle. (Pubmed Central) -  Oct 7, 2020   
    The fetal isoform is present in prenatal stages and is involved in the development of the neuromuscular system whereas the adult isoform prevails thereafter, except after denervation when the fetal form is re-expressed throughout the muscle. This review will summarize the structural and functional differences between the two isoforms and outline congenital and autoimmune myasthenic syndromes that involve the isoform specific AChR subunits.
  • ||||||||||  Clinical, Journal:  Differential Gut Microbiota and Fecal Metabolites Related With the Clinical Subtypes of Myasthenia Gravis. (Pubmed Central) -  Oct 7, 2020   
    Moreover, combinatorial biomarkers containing 15 discriminative OTUs and 2 differential metabolites were capable of discriminating OMG and GMG from each other, as well as from HCs, with AUC values ranging from 0.934 to 0.990. In conclusion, different subtypes of MG harbored differential gut microbiota, which generated discriminative fecal metabolism.
  • ||||||||||  Review, Journal:  Primary Periodic Paralyses: A Review of Etiologies and Their Pathogeneses. (Pubmed Central) -  Oct 4, 2020   
    Primary periodic paralyses are further classified on the basis of affected ion channels and other associated complications. Some of these periodic paralyses are hyperkalemic periodic paralysis (Na-channel mutation), hypokalemic periodic paralysis (Na- or Ca-channel mutation), Andersen's syndrome (K-channel mutation), etc.
  • ||||||||||  Review, Journal:  Fecal microbiota transplantation donation: the gift that keeps on giving. (Pubmed Central) -  Oct 2, 2020   
    Furthermore, data outcomes on recipients of FMT regarding donor's health co-morbidities, age, and weight are limited but emerging. The purpose of this review is to evaluate cost, safety, and accessibility in FMT donation.
  • ||||||||||  Journal:  The face of myasthenia gravis. (Pubmed Central) -  Oct 2, 2020   
    The purpose of this review is to evaluate cost, safety, and accessibility in FMT donation. No abstract available
  • ||||||||||  Biomarker, Clinical, Journal:  COVID-19 in MuSK Myasthenia Gravis: A Case Report. (Pubmed Central) -  Oct 1, 2020   
    Our data confirm that clinicians should look for DOK7-CMS patients when the clinical manifestation is an 'unexplained' LGMW, mainly if associated with non-specific changes in muscle biopsy. No abstract available
  • ||||||||||  Clinical, Review, Journal:  The Epidemiology and Clinical Manifestations of Autoimmunity in Selective IgA Deficiency. (Pubmed Central) -  Sep 30, 2020   
    Minimal if any associations are noted with myasthenia gravis, lichen planus, and multiple sclerosis. Finally, more recent data provide clues on the possible immunologic mechanisms that lead to the association of IgA deficiency and autoimmunity; these lessons are important for understanding the etiology of autoimmune disease.
  • ||||||||||  [VIRTUAL] Recurrent Malignant Thymoma in Refractory Myasthenia Gravis () -  Sep 30, 2020 - Abstract #ANA2020ANA_526;    
    In refractory MG patients, recurrent thymoma should be considered even with previous surgical resection of the thymoma. Although definitive treatment for patients that present with comorbid thymoma and MG is surgical resection of the neoplasm along with immunotherapy, however, the outcome could be varied, and further study is needed for optimal management of such refractory MG patient with multiple recurrent thymoma.
  • ||||||||||  [VIRTUAL] Droopy Eyelids: Think Beyond the Conventional Paradigm! () -  Sep 30, 2020 - Abstract #ANA2020ANA_524;    
    Inheritance of CPEO can be sporadic, maternal, autosomal dominant or recessive with mutations in the mitochondrial or nuclear DNA genes (POLG, C10orf2, RRM2B, SLC25A4, POLG2, DGUOK, and SPG7).4 POLG mutations can either cause isolated CPOE with proximal myopathy or an additional multisystemic syndrome characterized by variable degrees of axonal neuropathy, ataxia, sensorineural hearing loss, depression, parkinsonism, hypogonadism, and cataracts called CPEO plus syndrome3, as seen in our patient. Management of CPEO and its subsets require a multifaceted approach with neurology, ophthalmology, genetics, and cardiology, with symptomatic treatment markedly improving the patient’s quality of life.