Myasthenia Gravis
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  • ||||||||||  disulfiram / Generic mfg.
    Journal:  A class of chemical compounds enhances clustering of muscle nicotinic acetylcholine receptor in cultured myogenic cells. (Pubmed Central) -  Aug 22, 2024   
    The effects were higher than that of disulfiram, a clinically available aldehyde dehydrogenase inhibitor, which we identified to be the most competent preapproved drug to enhance ATF2-luciferase activity in the same assay system...Extensive docking simulation and binding structure prediction of the four compounds with all available human proteins using AutoDock Vina and DiffDock showed that the four compounds were unlikely to directly bind to MuSK or Dok7, and the exact target remained unknown. The identified compounds are expected to serve as a seed to develop a novel therapeutic agent to treat defective NMJ signal transmission.
  • ||||||||||  Journal:  Delayed Diagnosis of Thymoma in Ocular Myasthenia Gravis. (Pubmed Central) -  Aug 21, 2024   
    The presented inflammatory proteins that distinguish AChR+ MG are promising serum biomarkers for validation in prospective studies to allow for molecular signatures for patient subgroup stratification and monitoring of treatment response. No abstract available
  • ||||||||||  pantoprazole / Generic mfg.
    Superior Mesenteric Artery Syndrome Masked by Rheumatological Conditions (Exhibit Hall E) -  Aug 20, 2024 - Abstract #ACG2024ACG_5531;    
    She was placed on pantoprazole and improved after rheumatologic conditions were treated...This case emphasizes that SMA syndrome should be part of the differential in patients with nonspecific GI symptoms in patients with complicated rheumatologic conditions. Figure: A. Esophageal ulcer B. Stomach with bilious vomit C. Nasojejunal tube placement D. CT scan showing SMA syndrome
  • ||||||||||  prednisone / Generic mfg., methotrexate / Generic mfg.
    Precipitating Paralysis: An Unexpected Complication After Endoscopy (Exhibit Hall E) -  Aug 20, 2024 - Abstract #ACG2024ACG_4642;    
    Figure: Figure 1. EGD showed a moderate semi-solid food bezoar in the stomach, although the esophagus appeared normal with no active food bolus present.
  • ||||||||||  Vectibix (panitumumab) / Amgen
    A Case of Prolonged Generalized Weakness in a Patient With Metastatic Rectal Cancer 6 Weeks After Last Dose of Panitumumab (Exhibit Hall E) -  Aug 20, 2024 - Abstract #ACG2024ACG_4374;    
    This case highlights the need for vigilant monitoring and replacement of serum potassium and magnesium in metastatic colorectal cancer patients on Panitumumab, extending from initiation of agent to at least 8 weeks post-therapy. Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
  • ||||||||||  Rare Case of Thymoma Metastasizing to the Liver as an Incidental Finding (Exhibit Hall E) -  Aug 20, 2024 - Abstract #ACG2024ACG_3605;    
    Figure: Figure 1: Axial section of MRI abdomen with and without contrast, T2-weighted image showing a liver lesion in segment 3, measuring 18.4 x 19.2 mm. The lesion exhibits intermediate signal intensity and intense restricted diffusion (indicated by red *)
  • ||||||||||  prednisone / Generic mfg.
    A Case of Esophageal Variceal Hemorrhage With Normal Portal Pressures: Lessons From the Baveno VII Consensus on Porto-Sinusoidal Vascular Disorder (Exhibit Hall E) -  Aug 20, 2024 - Abstract #ACG2024ACG_3562;    
    Case Description/ A 75-year-old woman with a history of myasthenia gravis on chronic prednisone, type 2 diabetes, coronary artery disease post-percutaneous coronary intervention, scleroderma, and polycythemia vera, presented with hematemesis leading to hemorrhagic shock...Given the patient's clinical signs of portal hypertension and the exclusion of cirrhosis and of other causes of portal hypertension, PSVD can be diagnosed. The patient also had a diagnosis of polycythemia vera, myasthenia gravis, and scleroderma, which are all associated with PSVD.
  • ||||||||||  Lost and Found: A Unique Foreign Body Gastrointestinal Case Report (Exhibit Hall E) -  Aug 20, 2024 - Abstract #ACG2024ACG_2925;    
    This case potentially provides insights into both diagnostic and therapeutic options for patients with foreign bodies within the appendix. Figure: A. Earring in the appendiceal orifice B. Foreign body removal
  • ||||||||||  Rituxan (rituximab) / Roche
    Statin-Induced Autoimmune Necrotizing Myositis: An Unusual Case of Dysphagia (Exhibit Hall E) -  Aug 20, 2024 - Abstract #ACG2024ACG_1112;    
    Case Description/ A 63-year-old male presented with dysphagia to solids and liquids for two weeks, refractory to famotidine...He was started on Atorvastatin about one month before the symptoms began and recently finished a 7-day course of Bactrim for right lower extremity cellulitis...In the ICU, he received plasma exchange transfusions, rituximab, and IV steroids for treatment of necrotizing myositis...Following the IVIG and a prednisone taper, there was significant improvement in symptoms...Some physicians may use IVIG as a first-line therapy, particularly for patients at high risk of poor outcomes like our patient, or as monotherapy, which may be preferred in patients who are at increased risk of developing glucocorticoid-related side effects. Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
  • ||||||||||  methotrexate / Generic mfg., azathioprine / Generic mfg.
    A Case of Dysphagia Secondary to Necrotising Autoimmune Myopathy Triggered by COVID-19 (Exhibit Hall E) -  Aug 20, 2024 - Abstract #ACG2024ACG_1107;    
    Certain antibodies such as anti-signal recognition particle (SRP) and Anti-HMGCR may be present. Treatment typically involves steroids and immunosuppressive agents like methotrexate, azathioprine, or IVIG.
  • ||||||||||  Tai'ai (telitacicept) / Rongchang Pharma
    Enrollment open, Trial completion date, Trial primary completion date:  A Study of Telitacicept for the Treatment of Generalized Myasthenia Gravis (RemeMG) (clinicaltrials.gov) -  Aug 19, 2024   
    P3,  N=180, Recruiting, 
    Treatment typically involves steroids and immunosuppressive agents like methotrexate, azathioprine, or IVIG. Not yet recruiting --> Recruiting | Trial completion date: Jul 2027 --> Oct 2027 | Trial primary completion date: Apr 2026 --> Jul 2026
  • ||||||||||  Journal:  Thoracoscopic thymectomy for myasthenia gravis and non-invasive thymoma after COVID-19 pneumonia (Pubmed Central) -  Aug 14, 2024   
    Plasmapheresis and glucocorticosteroids are effective in addition to anticholinesterase therapy at the stages of perioperative support for correction of neurological status in patients with myasthenia combined with chronic obstructive pulmonary disease and pulmonary hypertension. Outpatient direct anticoagulants are advisable considering the need for prolonged postoperative prevention of thrombotic events.
  • ||||||||||  Vyvgart (efgartigimod alfa-fcab) / argenx, Broteio
    Retrospective data, Journal:  Efgartigimod in refractory autoimmune myasthenia gravis. (Pubmed Central) -  Aug 14, 2024   
    Patients required more frequent dosing compared to the ADAPT phase 3 trial. In 80% of the patients concurrent medication could be reduced or discontinued.
  • ||||||||||  Rituxan (rituximab) / Roche
    Retrospective data, Journal:  Rituximab alone is as effective as associated with steroids on naive patients with generalized myasthenia gravis. (Pubmed Central) -  Aug 12, 2024   
    DHA ameliorated EAMG by inhibiting the PI3K-AKT signaling pathway, regulating CD4+?T cells and modulating gut microbiota, providing a novel therapeutic approach for the treatment of MG. We suggest that RTX alone is as effective as RTX-CS in MG patients, indicating that avoiding steroids could reduce side effects, decrease rescue therapies, and not affect MG outcomes.
  • ||||||||||  Review, Journal:  Paraneoplastic neurological syndromes of small cell lung cancer. (Pubmed Central) -  Aug 9, 2024   
    Managing the underlying tumor is the best treatment approach for most paraneoplastic syndromes. Therefore, early diagnosis of small cell lung cancer may significantly improve the prognosis of paraneoplastic syndromes associated with it.
  • ||||||||||  venlafaxine / Generic mfg., clonazepam / Generic mfg.
    Muscle Augmentation Paradox: Contrasting Therapeutic Approaches in Myasthenia Gravis and Parkinson's Disease (Poster Hall (Exhibit Hall A)) -  Aug 9, 2024 - Abstract #MDSCongress2024MDS_Congress_1946;    
    While MG management may caution against increased muscle workload, PD therapy often incorporates strength enhancement as a pivotal component. This dichotomy necessitates a personalized, multidisciplinary approach, emphasizing the integration of neuropharmacological treatment with physical and psychiatric interventions to tailor therapeutic strategies effectively to each patient's unique clinical profile.
  • ||||||||||  The Impact of Camp Lejeune Toxins on the Development of Parkinsonisms and Movement Disorders (Poster Hall (Exhibit Hall A)) -  Aug 9, 2024 - Abstract #MDSCongress2024MDS_Congress_406;    
    Also, the combination of toxin exposure in those dually exposed to AO and Camp Lejeune toxins, seem to contribute to a higher number of co-incident movement and neurologic disorders compared to the general population. Transformation from ET to PD only occurs in 3.6% of the general population, as opposed to 66.7% in our cohort.
  • ||||||||||  Journal:  The speed of completion of the decremental responses on repetitive nerve stimulation. (Pubmed Central) -  Aug 8, 2024   
    The decremental response completed more rapidly in deltoid than in APB which may be related to the lower safety factor also documented by this study. Unexpected early completion of the decrement such as at the second response in RNS is not a technical error but may be an extreme of the rapid completion in deltoid, a proximal muscle.
  • ||||||||||  Review, Journal:  Treating myasthenia gravis beyond the eye clinic. (Pubmed Central) -  Aug 7, 2024   
    Patients requiring bulbar muscle support may need rescue therapies including plasma exchange and intravenous immunoglobulin (IVIg). Newer therapeutic targets include those against the B lymphocytes, complement system, neonatal Fc receptors (FcRn) and various other elements of the immune system.
  • ||||||||||  Vyvgart (efgartigimod alfa-fcab) / argenx, Broteio
    Review, Journal:  Efgartigimod as a novel FcRn inhibitor for autoimmune disease. (Pubmed Central) -  Aug 7, 2024   
    To suppress the function of FcRn, which is beneficial to the treatment of IgG-driven autoimmune disorders like MG, CIDP, ITP, and stiff person syndrome. We review the rationale, clinical evidence, and future perspectives of efgartigimod for the treatment of autoimmune disease.
  • ||||||||||  Keytruda (pembrolizumab) / Merck (MSD)
    Journal:  Pembrolizumab-induced myasthenia gravis: Two patients' experiences. (Pubmed Central) -  Aug 7, 2024   
    The second patient is an 80-year-old woman with recurrent serous endometrial carcinoma who developed isolated ocular myasthenia after her second cycle of pembrolizumab. The symptoms and physical examination findings described here illustrate the breadth of symptom severity associated with pembrolizumab-induced MG and importance of early identification and treatment to minimize symptoms and improve outcomes.
  • ||||||||||  Review, Journal:  Myasthenia gravis: the future is here. (Pubmed Central) -  Aug 6, 2024   
    In this Review, we delve into the various subgroups of MG, stratified by age, autoantibody type, and histology of the thymus with neoplasms. Furthermore, we explore both current and potential emerging therapeutic strategies, shedding light on the evolving landscape of MG treatment.