2015
DOI: 10.2298/vsp131111039n
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A misdiagnosed myasthenia gravis with anti-muscle-specific tyrosine kinase antibodies with possible childhood onset

Abstract: The presented case confirms that childhood onset myasthenia gravis associated with anti-muscle-specific tyrosine kinase antibodies is often with atypical presentation and spontaneous remissions, so it could be easily misdiagnosed.

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Cited by 3 publications
(2 citation statements)
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“…Similarly to adult patients, most pediatric patients with MuSK‐MG are female . Prepubertal patients with MuSK‐MG with long‐term remission without treatment have been frequently reported, and these patients usually have predominantly oculobulbar features . Spontaneous improvement in childhood MuSK‐MG could be related to favorable developmental changes in NMJs; otherwise, this is currently poorly understood.…”
Section: Special Populationsmentioning
confidence: 99%
“…Similarly to adult patients, most pediatric patients with MuSK‐MG are female . Prepubertal patients with MuSK‐MG with long‐term remission without treatment have been frequently reported, and these patients usually have predominantly oculobulbar features . Spontaneous improvement in childhood MuSK‐MG could be related to favorable developmental changes in NMJs; otherwise, this is currently poorly understood.…”
Section: Special Populationsmentioning
confidence: 99%
“…Tacrolimus (Prograf) and cyclosporine (Neoral), both of which are now frequently used in Japan after being approved by medical insurance, are both calcineurin inhibitors, and their mechanism of action is to suppress T-cell activity. In Japan, tacrolimus was covered by insurance several years before cyclosporin, and has been used safely in many pediatric patients, 3,93,94 whereas cyclosporin is still relatively rarely used, 3,92 but has been reported to be effective against MuSK-MG. 95 Tacrolimus is used at a fixed dose of 3 mg/d in adults, 96,97 but in children it is started at a dose of 0.05 mg/kg/d once daily, taking body weight into consideration, and then at a dose of 0.1-0.2 mg/kg/d once daily. 94,98 It is usually administered after dinner, and the trough blood level is measured in the morning of the next day and adjusted, aiming for a concentration of 3-5 ng/mL, and without exceeding 10 ng/mL.…”
Section: Immunosuppressantsmentioning
confidence: 99%