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A Case of COVID-19 Related Myasthenic Crisis: Lessons Learned

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International Journal of Clinical Medicine 2023年第8期11卷 333-337页

作者： Folajimi M. Otubogun Adegoke M. Fatunwase Olaniyi M. Fowosola Khadijat M. Alli Ojuolape O. Okedara Bamidele S. Osalusi Department of Medicine Federal Medical Centre Lagos Nigeria Department of Internal Medicine Faculty of Clinical Sciences University of Medical Sciences Ondo Nigeria Department of Internal Medicine Olabisi Onabanjo University Teaching Hospital Sagamu Nigeria Department of Internal Medicine Faculty of Clinical Sciences Olabisi Onabanjo University Ago-Iwoye Nigeria

Background: COVID-19 was initially described to affect the respiratory system, it is now known to affect other systems and present in a myriad of ways. This has often proved to be a diagnostic and therapeutic challenge to clinicians and stretched healthcare resources, sometimes with poor outcomes. We report on an atypical presentation of SARS-CoV-2 infection as an acute exacerbation of myasthenia gravis in a low resource setting. Case Presentation: A middle aged male with myasthenia gravis presented with a three weeks’ history of worsening generalized weakness and three days’ history of new-onset dysphagia with no history of fever and cough. After a few days of apparent improvement, the patient developed progressive respiratory distress. Further evaluation confirmed bilateral pneumonia and COVID-19. Conclusion: There is a need for clinicians and health service providers to have a low threshold for suspicion and testing for COVID-19 in patients with pre-existing medical conditions and immunomodulatory therapy such as myasthenia gravis.

关键词： myasthenia gravis COVID-19 SARS-COV-2 Low Resource Settings

Sequence analysis of a mouse mAb against AchR

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延边大学医学学报 1995年第2期 79-82页

作者： Meng Fanping Yang Kangjuan Y. Graus M. de Baets(Department of Microbiology, Yanbian Medical College)(Department of Biology, Yanbian Medical College)(Department of Immunology, Faculty of Medicine, University of Limburg, Maastricht,The Netherlands)

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ＳｅｑｕｅｎｃｅａｎａｌｙｓｉｓｏｆａｍｏｕｓｅｍＡｂａｇａｉｎｓｔＡＣｈＲＭｅｎｇＦａｎｐｉｎｇ；ＹａｎｇＫａｎｇｊｕａｎ；Ｙ．Ｇｒａｕｓ；Ｍ．ｄｅＢａｅｔｓ（ＤｅｐａｒｔｍｅｎｔｏｆＭｉｃｒｏｂｉｏｌｏｇｙ，ＹａｎｂｉａｎＭｅｄｉｃａｌＣｏｌｌｅ...

关键词： autoantibodies: AChR PCR nucleotide sequences myasthenia gravis

An open add-on study on cyclophosphamide in patients with refractory myasthenic crisis

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Journal of Medical Colleges of PLA(China) 2003年第1期18卷 45-47页

作者：蒋建明涂来慧吴涛张仁琴丁素菊蔡建英 Department of Neurology Changhai HospitalSecond Military Medical University Department of Neurology Changhai HospitalSecond Military Medical UniversityShanghai 200433China

Objective: To assess the efficacy and side effects of cyclophosphamide on refractory myasthenic crisis. Methods: Five patients of myasthenic crisis refractory to usual comprehensive treatment, entered an open additional study with cyclophosphamide 200 mg VD q. d or 400 mg VD q. o. d with 6-10 g of total dosage. The patients were followed up for 1-8 years. Results: All the 5 patients were effectively treated with obvious remission in 3 and improvement in 2. Two patients have returned to partial work. The side effects were tolerable. Conclusion: The present clinical trial showed that cyclophosphamide was effective, particularly in a long term as an additional therapy for treating MG patients with refractory crisis of myasthenia gravis.

关键词： myasthenia gravis crisis cyclophosphamide therapy

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Expression and clinical significance of EGFR, PCNA, Bcl-2 and Bax in thymoma

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Journal of Medical Colleges of PLA(China) 2002年第4期17卷 299-303页

作者：薛志强王如文蒋耀光赵云平 Department of Thoracic Surgery Daping Hospital Third Military Medical University Chongqing 400042 China

Objective:To study the expressions and clinical significances of PCNA, EGFR, Bcl-2 and Bax in thymoma. Methods: The expressions of EGFR, PCNA, Bcl-2 and Bax in 46 cases of thymoma and 11 cases of normal thymus were detected with S-P immunohistochemistry. The results were analyzed with the pathologic indexes. Results: The positive rates of EGFR, Bcl-2 and Bax in normal thymus were 18. 2%, 9. 1%,and 18.2% respectively, while in thymoma were 71.7%, 41.3%, and 15.2% separately. The expression of EGFR in thymoma was significantly correlated with Masaoka staging and Levine classification. The survival rate of EGFR negative patients was significantly higher thanthat of EGFR positive patients (P＜0. 01). PCNA labelling index was significantly higher in thymoma as (4.00±1.87)% than in normal thymus, (2.68±0. 62)% , which was significantly correlated with Levine classification. The expression of Bcl-2 in thymoma was also significantly correlated with Levine classification. The survival rate of Bcl-2 negative patients was significantly higher than that of Bcl-2 positive patients (P＜0. 01). The expression of PCNA, EGFR, Bcl-2and Bax in thymoma had no correlation with histologic type and myasthenia gravis (MG) (P＞0. 05). Conclusion: The expression of EGFR may be involved in the occurrence and development of thymoma. EGFR can be regarded as a supplementary predictor for Masaoka staging so as to predict the progression *** expression of Bcl-2 may contribute to the occurrence of thymic carcinoma and Bcl-2 can be used as a biomarker identifying thymic carcinoma.

关键词： thymoma epidermal growth factor receptor proliferating cell nuclear antigen Bcl-2 Bax thymic carcimoma myasthenia gravis

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Endoplasmic reticulum stress contributes to acetylcholine receptor degradation by promoting endocytosis in skeletal muscle cells

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Endoplasmic reticulum stress contributes to acetylcholine re...

Over-expression of CCL25 on TECs from MG patients affects the differentiation of ETPs

第十届全国免疫学学术大会

作者： Xiaonan Zhao Shiqian Huang Ailian Du Congfeng Xu Shanghai Jiaotong University School of Medicine Department of Neurology Tongren Hospital Shanghai Jiaotong University School of Medicine

INTRODUCTION AND OBJECTIVES After binding by acetylcholine released from a motor neuron,a nicotinic acetylcholine receptor at the neuromuscular junction produces a localized end-plate potential,which leads to muscle *** turnover and renewal of acetylcholine receptors contributes to the pathogenesis of myasthenia *** study would like to unveil if and how endoplasmic reticulum(ER)stress is involved in regulating turnover of acetylcholine *** Utilizing ER inducers such as tunicamycin and thapsigargin,we monitored the endocytosis and degradation of acetylcholine receptor in C2C12 myocytes by flow cytometry,confocal microscopy and western blotting,and further tracked the degradation pathway of acetylcholine receptors with diverse *** knockdown of ER stress proteins such as XBP-1 was also applied to confirm the function of ER stress in regulating acetylcholine receptor endocytosis and *** In the present study,we demonstrated that endoplasmic reticulum(ER)stress contributes to acetylcholine receptor degradation in C2C12 *** stress promotes acetylcholine receptor endocytosis and lysosomal degradation,which was dampened by blocking endocytosis or treating with lysosome *** down of ER stress protein XBP-1 inhibited acetylcholine receptor endocytosis and degradation,while rescue assay restored its endocytosis and degradation,confirming the effects of ER stress on promoting endocytosis-mediated degradation of junction acetylcholine *** Our studies identify ER stress as a factor promoting acetylcholine receptor degradation through accelerating endocytosis in muscle *** ER stress and/or endocytosis might provide a novel therapeutic approach for myasthenia gravis.

关键词： Endoplasmic reticulum stress acetylcholine receptor endocytosis protein degradation skeletal muscle cells myasthenia gravis

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Over-expression of CCL25 on TECs from MG patients affects th...