Myasthenia Gravis
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  • ||||||||||  Patient Education Regarding Complications To Anesthetic Approach In Patient With Myasthenia Gravis (Hall C) -  Aug 15, 2022 - Abstract #ASA2022ASA_4016;    
    Due to chronic anti-coagulation this was a high risk approach requiring extensive communication between specialties for optimal pre-procedure medication scheduling. Secondary to sub optimal patient education, the patient was unaware of how his history could complicate anesthesia which was extremely important because of the severity of the potential effects of patient noncompliance in this case.
  • ||||||||||  Perioperative Management Of Myasthenia Gravis During Robot-assisted Radical Prostatectomy Surgery (Hall C) -  Aug 15, 2022 - Abstract #ASA2022ASA_2501;    
    Moreover, extremities are often tucked, making it difficult to closely monitor twitches. In this case, we describe the peri-operative management of a 57 year old male with a history of sero-negative Myasthenia gravis with multiple risk factors for post-op mechanical ventilation including disease duration of 12 years and high dose pyridostigmine (270mg daily) who presented for a robot-assisted radical prostatectomy.
  • ||||||||||  Perioperative Management Of Patient With Myasthenia Gravis And Recent Myasthenic Crisis (Hall C) -  Aug 15, 2022 - Abstract #ASA2022ASA_2416;    
    Despite full reversal and appropriate titration of anesthetics, she was unable to generate adequate tidal volumes and remained intubated after her procedure. We discuss the perioperative management and anesthetic concerns of patients with myasthenia gravis and recent myasthenic crisis as well as predictive factors for postoperative respiratory failure.
  • ||||||||||  Myasthenia Gravis: Can We Avoid Mechanical Ventilation In Patients In Acute Crisis? (Hall C) -  Aug 15, 2022 - Abstract #ASA2022ASA_2372;    
    Current recommendations for acute myasthenia gravis exacerbation suggest early elective intubation with positive pressure ventilation, but these interventions are not without complications such as oral/airway trauma, barotrauma, and hemodynamic changes. In order to avoid intubation and mechanical ventilation, this patient received plasma exchange therapy that led to immediate and drastic improvement in symptoms.
  • ||||||||||  Myasthenia Gravis And The Unlikely Combination Case With Otolaryngology And Gynecologic Oncology (Hall C) -  Aug 15, 2022 - Abstract #ASA2022ASA_952;    
    Unique intraoperative considerations involved jet ventilation, avoidance of neuromuscular blockade, and abdominal insufflation in steep trendelenburg position. Patient was extubated early on postoperative day 1, downgraded from ICU on postoperative day 2, and discharged home without complication on postoperative day 3.
  • ||||||||||  fentanyl citrate / Generic mfg., prednisone / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
    Seeing Double! Anesthetic Management During The Delivery Of A High-risk Pregnant Patient With Myasthenia Gravis - A Case Report (Virtual - Mobile App) -  Aug 15, 2022 - Abstract #ASA2022ASA_303;    
    During this presentation, neurology was consulted and recommended starting pyridostigmine and a course of solumedrol...CSE was performed with 25 mcg of intrathecal fentanyl...There were no respiratory complications after dosing the intrathecal opioid and gradually loading the epidural with local anesthetic proved efficacious. Clear communication regarding intra-operative and post-operative contingency plans aided in the success of this high-risk delivery.
  • ||||||||||  Review, Journal:  Novel copy number variation of COLQ gene in a Moroccan patient with congenital myasthenic syndrome: a case report and review of the literature. (Pubmed Central) -  Aug 14, 2022   
    In (seronegative) myasthenic patients, TPE may help to verify an uncertain diagnosis or to reveal possible muscle damage, allowing unnecessary therapy to be avoided. This clinical observation illustrates the important place of next-generation sequencing in the precise molecular diagnosis of heterogeneous forms of CMS, the appropriate management and targeted treatment, and genetic counseling of families, with a better characterization of the mutational profile of this rare disease in the Moroccan population.
  • ||||||||||  Retrospective data, Journal, Checkpoint inhibition:  Clinical features of immune checkpoint inhibitor-related myositis in patients with urological cancer (Pubmed Central) -  Aug 12, 2022   
    Immune-related myositis after ICI treatment is an immune-related adverse reactions (irAEs) with unique clinical and pathological features, commonly combined with cardiovascular adverse reactions. Immediate discontinuation of ICI and initiation of glucocorticoid therapy may improve the patient's condition in a timely manner.
  • ||||||||||  Retrospective data, Journal:  Thymectomy in ocular myasthenia gravis-prognosis and risk factors analysis. (Pubmed Central) -  Aug 12, 2022   
    For OMG patients after thymectomy, RNS-positivity and histotype B2/B3 thymoma are independent predictors of conversion to GMG. On the other hand, thymic hyperplasia and stage I thymoma independently predict CSR.
  • ||||||||||  Enrollment open:  SP Thoracic IDE Study (clinicaltrials.gov) -  Aug 10, 2022   
    P=N/A,  N=30, Recruiting, 
    TT revaccination is effective in MG patients with stable disease irrespective of their thymectomy status and medication and does not alter the composition of the lymphocyte compartment. Not yet recruiting --> Recruiting
  • ||||||||||  Retrospective data, Journal:  Efficiency of ectopic thymectomy by three surgical approaches in non-thymomatous myasthenia gravis. (Pubmed Central) -  Aug 4, 2022   
    Both the right unilateral thoracoscopic and thoracoscopic subxiphoid approaches have advantages over the transsternal approach in short-term postoperative recovery. Transsternal approach is still the best choice for ectopic thymectomy while thoracoscopic subxiphoid approach show the potential as an alternative way.
  • ||||||||||  Journal, IO biomarker:  Rippling muscle disease with myasthenia gravis (Pubmed Central) -  Aug 4, 2022   
    CAV3 gene mutations are recognized as causes of congenial RMD whereas acquired RMD is associated with myasthenia gravis. Acquired RMD is rarely reported in Japan, but should be kept in mind as a condition treatable with immunotherapy.
  • ||||||||||  Journal:  A case of autoimmune hepatitis with thymoma and myasthenia gravis. (Pubmed Central) -  Aug 3, 2022   
    MG symptoms and liver damage gradually improved, she was then treated with chemotherapy and radiation for thymoma and underwent thymectomy, now showing no relapse of AIH or MG. We report the first case of MG developing immediately after the introduction of prednisolone for AIH complicated with thymoma.
  • ||||||||||  Review, Journal:  Myasthenia gravis and pregnancy: impact and approach (Pubmed Central) -  Aug 3, 2022   
    Myasthenia gravis would not significantly effects on pregnancy; however, pregnancy can exacerbate the disease, especially during the first trimester or after delivery. The approach to pregnant women with myasthenia gravis must be multidisciplinary and involves the adjustment of pharmacological treatment and constant monitoring.
  • ||||||||||  Journal:  Clinical profile of 80-year-old and older thyroid eye disease patients. (Pubmed Central) -  Jul 30, 2022   
    TED among octo- and nonagenarians has unique patterns, with different demographic features, more exposed to diplopia, hypothyroidism, association with myasthenia gravis, and bilateral involvement. Special attention should be given when medically managing this subgroup.
  • ||||||||||  Review, Journal:  Unraveling the Immune Microenvironment of Thymic Epithelial Tumors: Implications for Autoimmunity and Treatment. (Pubmed Central) -  Jul 29, 2022   
    A number of phase I and II clinical trials have already demonstrated significant, type-specific clinical efficacy of PD-L1 inhibitors, even though substantial limitations in their utilization derive from their immune-mediated adverse effects. Moreover, the completed clinical studies involved relatively restricted patient samples and an expansion in the enrolled cohorts is required, so that more trustworthy conclusions regarding the benefit from ICIs in TETs can be extracted.