Validación de la prueba de hielo en oftalmoparesia por miastenia grave

Ramirez-Antunez, Ángel G; Garcı́a-Ramos, Guillermo; Estañol-Vidal, Bruno; Juárez-Flores, Alejandra

doi:10.33588/rn.5709.2013193

Cited by 2 publications

(1 citation statement)

References 34 publications

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“…Single fiber electromyography is the most sensitive tool for the diagnosis of MG, it is positive in 95% of patients with generalized MG and in 90-95% with ocular MG; however, it is not yet available in West Mexico, a significant delay compared to other countries where is available in the majority of reference centers 2,18,19 . In a particular patient with high clinical suspicion, the diagnosis was made using the ice pack test (with high positive predictive value), after being negative for both ACRA and supra-maximal repetitive nerve stimulation test 20 .…”

Section: Discussionmentioning

confidence: 99%

Myasthenia gravis in a reference Western Mexican Hospital: Comparison of a new cohort versus a historical one

Parada-Garza¹,

Miranda-García²,

González-Jaime³

et al. 2020

RMN

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Background: Myasthenia gravis (MG) is a post-synaptic autoimmune disease of the neuromuscular junction, whose cardinal manifestations are weakness and fatigue. Objective: The objective of the study was to report a cohort of patients with a diagnosis of MG in a West Mexican hospital and compare the clinical profile, diagnostic, and therapeutic approach and prognosis against a previously published cohort of the same hospital. Materials and methods: Consecutive patients included in two cohorts: the first one already published from 1999 to 2007 and the second one reported here from 2008 to 2018. Results: The most recent cohort included 39 patients, 23 women (59%), with an average age of 50 years, and superior to the previous cohort (43 years). Hypertension (39%) and diabetes (18%) were observed with a marked increase in the current cohort. The distribution in the Osserman staging was very similar. The positivity of acetylcholine receptor antibodies (ACRA) increased from 37% to 88%. In both cohorts, most patients received pyridostigmine and in two-thirds steroids. The previous cohort recorded 4% of patients treated with a steroid-sparing immunosuppressant, contrasting with 90% (azathioprine 85%, and mycophenolate 5%) of the current cohort. Thymectomy was a less frequent practice in 12%. Mortality showed a significant decrease from 16% to 0%. Conclusion: Differences were observed among the cohorts, highlighting in the most recent one a higher age, the appearance of chronic-degenerative diseases, greater positivity to ACRA, optimization of pharmacological management, less thymectomy, and no mortality. Replicas of this work in other hospital settings are pertinent.

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