Myasthenia gravis

Myasthenia gravis
ـــــــــــــــــــــــــــــــــــــــــــــــــــــــ
it's an autoimmune disease of the (NMJ) neuromuscular junction
characterized by rapid fatigability of the skeletal muscles


Etiology;
>>it's an autoimmune disease in (NMJ) in which antibodies to
nicotinic receptors (Nm) are produced

>>these Abs attack the receptors , thus decrease no. Nm of avail. for Ach
for skeletal muscle contraction


Diagnosis;
>>small doses of Neostigmine(im) + Atropine (to block unwanted M-action
of Ach)

OR

>>Edrophonium test;no need for Atropine (edrophonium has no M-action)


Result;
>>if improvement of skeletal muscle weakness & increase Ach,,,,,,Myasthenia gravis



TTT;
1-anticholinesterase agent as (neostigmine & pyridostigmine)
2-immunosuppressive as (corticosteroids>>>>decrease Ag-Ab reaction)
3-surgical removal of thymus gland


by :-
Dr / Eslam Nagah