Seronegative myasthenia gravis with bladder dysfunction

Marouani, I.; Kraoua, Ichraf; Benrhouma, H.; Rebai, Ibtihel; Rouissi, Aida; Koubaa, Salah; Turki, Ilhem; Dziri, C.; Gouider-Khouja, N.

doi:10.1016/j.neurol.2011.07.017

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…Among the few existing studies, Dixon et al [ 10 ] reported cases of stress urinary incontinence in limb-girdle muscular dystrophy and Dickson et al [ 11 ] reported cases of myotonic dystrophy, both likely due to pelvic floor weakness. In MG, a variety of LUTS have been reported in case reports, from overactive bladder and urinary incontinence [ 2 , 3 ] to retention [ 4 ] (Table 3 ). However, it remains uncertain to what extent MG contributes to the LUTS.…”

Section: Discussionmentioning

confidence: 99%

“…Although the muscles directly associated with the lower urinary tract (LUT) are smooth muscles, they are further surrounded by the striated muscles of the external sphincter and the pelvic floor. LUT symptoms (LUTSs) have been reported in case reports of MG, varying from overactive bladder and urinary incontinence [ 2 , 3 ] to retention [ 4 ]. However, it remains uncertain to what extent MG pathology contributes to the LUTS.…”

Section: Introductionmentioning

confidence: 99%

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Lower Urinary Tract Symptoms in Myasthenia Gravis

2021

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It remains uncertain to what extent lower urinary tract (LUT) symptom (LUTS) is a comorbidity of myasthenia gravis (MG). We prospectively administered a LUTS questionnaire devised for detecting neurogenic pelvic organ dysfunction (not validated) in an MG group and a healthy control group and compared the results. The MG group comprised 21 patients: 15 women and 6 men, with age range 22–73 (mean 47) years, illness duration range 0.2–8 (mean 3.5) years, median Myasthenia Gravis Foundation of America (MGFA) grade 2, all walking independently. Therapies included thymectomy in 17, predonisolone 5–20 mg/day in 10, and pyridostigmine bromide 60–180 mg/day in 9 patients. The control group, who were undergoing an annual health survey, comprised 235 consecutive subjects: 120 women and 115 men, with age range 30–69 (mean 48) years. The questionnaire had 9 questions. Each question was scored from 0 (none) to 3 (severe) with an additional quality of life (QOL) index scored from 0 (satisfied) to 3 (extremely dissatisfied). Statistical analysis was made using Student’s t test. Compared with the control subjects, the frequency of LUTSs in the MG patients was significantly higher for daytime frequency (43%; p < 0.01), nocturia (24%; p < 0.01), and urinary incontinence (43%; p < 0.05). The LUTS-related QOL index for the MG patients was significantly higher for MG patients as a whole than that for all control patients (29%) (p < 0.05). In conclusion, our study results showed that MG patients had significantly more LUTSs (overactive bladder) than healthy control subjects and had worse LUTS-related QOL; therefore, amelioration of LUTS in MG is important.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lower Urinary Tract Symptoms in Myasthenia Gravis

2021

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“…18 Marouani et al retained bladder dysfunction with urethral sphincter hypertonia and detrusor areflexia in a myasthenic girl. 19 On the other hand, Pannek and Grigoleit reported a 6-year-old boy who had congenital MG and suffered from OAB starting after initiating pyridostigmine and improving through functional electrical stimulation. 20 Likewise, Antoniou et al recovered urodynamic detrusor overactivity by using pretibial nerve stimulation in a young myasthenic woman.…”

Section: Discussionmentioning

confidence: 99%

The impact of myasthenia gravis on lower urinary tract functions

Akan

Polat

Çulha

et al. 2021

Int J Clinical Practice

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Aim To assess the functions of the lower urinary tract (LUT) in patients with myasthenia gravis (MG). Materials and Methods A total of 36 patients (18 males and 18 females) with MG and 29 healthy controls were enrolled. Participants completed a 3‐day voiding diary and responded to questionnaires "Overactive Bladder Symptom Score" (OABSS) and "International Consultation on Incontinence‐Short Form" (ICIQ‐SF). All patients underwent uroflowmetry and ultrasonography (US). The data were compared based on the onset of disease and serological status. Results The most common urinary symptoms were nocturia (80.5%), incontinence (61%) and urgency (47%). OABSS was higher in patients than controls (P = .008). Duration of urinary symptoms was longer, and nocturia was more common in late‐onset MG (LOMG) than in early‐onset MG (EOMG; P = .029, P = .023). The duration of disease and urinary symptoms statistically increased in ACh‐Ab (−) group compared with ACh‐Ab (+) group (P = .003, P = .027). Night‐time urination frequency significantly increased while daytime voided volume (VV) decreased in LOMG compared with EOMG (P = .003 and P = .01). Residual volume on the US was significantly higher in LOMG than that in EOMG (P = .004). The duration of disease was positively correlated with tQmax and daytime urination frequency (P = .013, r = .48; P = .016, r = .398). A negative association was found between duration of disease and daytime VV (P = .04, r = −.344). Conclusion LUT dysfunction may manifest disease in MG, particularly in late‐onset forms. The lack of ACh‐Ab seemed to prolong the duration of disease and urinary disturbances.

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“…After reviewing existing criteria for seronegative MG classification in dogs, we strongly believe the dog described here had seronegative MG, because of the clinical signs consistent with MG, positive edrophonium response, decremental response of the compound muscle action potential, and normalization of limb muscle weakness after anticholinesterase treatment. In humans, dysuria occurs in myasthenic patients, and there is also evidence for this in dogs , . It has been hypothesized that this is because of autoantibodies directed against ganglionic acetylcholine receptors in the autonomic nervous system .…”

Section: Discussionmentioning

confidence: 99%