Measles antibodies and autoantibodies in autoimmune disorders. (41/830)

Measles CF antibodies have been examined in the sera of patients with a variety of clinical disorders associated with the production of autoantibodies. Previous reports of high-titre reactions in DLE and chronic active hepatitis have been confirmed, the titres in the latter disorder being particularly elevated. Mean antibody titres to measles in patients with rheumatoid arthritis were significantly lower than in matched controls, and an inverse correlation between measles antibody levels and serum globulin levels was found. Measles antibody titres in patients with myasthenia gravis and primary biliary cirrhosis did not differ significantly from those found in controls. However, subdivision of patients with rheumatoid arthritis, myasthenia gravis and primary biliary cirrhosis showed that the presence of anti-nuclear antibody (ANA) was associated with significantly increased measles antibody levels compared with the ANA-negative sera. The presence of gastric parietal cell antibody or thyroid microsomal antibody did not appear to be associated with increased measles antibody levels, whether or not they occurred in association with previous anaemia or thyroid disease. Possible explanations for these findings in terms of immune complex formation and immune hyper-reactivity are discussed.  (+info)

Myasthenia gravis with membranous nephropathy, successfully treated with extended total thymectomy. (42/830)

A 46-year-old woman showed proteinuria and hematuria after left blepharoptosis, and revealed a histopathology of membranous nephropathy (MN) at renal biopsy. She was diagnosed as having myasthenia gravis (MG) because of a positive edrophonium test and anti-acetylcholine receptor (AchR) antibodies in serum. We found a decrease in anti-AchR antibodies after extended total thymectomy, in parallel with an improvement in both urinary findings and myasthenic symptoms. In this case, MG preceded MN and the thymectomy was effective for both diseases, suggesting that the thymus might play an important role in the pathogenesis of MN.  (+info)

Spontaneous diseases in a closed colony of Praomys (Mastomys) natalensis. (43/830)

In comparison with other rodents, the mastomys is unique as regards the patterns of neoplastic and non-neoplastic diseases that it develops, some of which may constitute suitable animal models for corresponding diseases of man. Among the spontaneous diseases commonly encountered in necropsies of 600 mastomys maintained in a closed colony were: (1) degenerative joint disease of diarthroses and interventricular disks, which develops regularly in the second year of life; (2) renal disease, a type of immune-complex glomerulonephritis, affecting approximately 80% of mastomys in the age bracket 18-36 months; (3) thymomas and thymic hyperplasia affecting 30% of mastomys by the time they are 2 years old or older; (4) a combination of thymoma and polymyositis in a mastomys showing serum-globulin reactivity, presumably auto-antibody against striated muscle; (5) beginning before the age of 1 year, replacement of the normal cell population of the lymphoid tissues by plasma cells, and intense plasma cell infiltration at many other organ and tissue sites; (6) haematopoietic neoplasms, without leukaemic blood, in 10% of mastomys; and (7) histamine-producing argyrophilic carcinoid tumours of the glandular stomach in approximately 60% of old male and 30% of old female mastomys. Additionally, other neoplasms not infrequently encountered in mastomys rarely occur in other rodent species; conversely some neoplasms commonly found in other rodents, including especially tumours of the lung and mammary gland and leukaemia, are rare or absent in mastomys.  (+info)

Lymphocyte subpopulation in neoplastic and non-neoplastic thymus and in blood of patients with Myasthenia gravis. (44/830)

The lymphocyte subpopulations in the thymus and in the blood were investigated in ten myasthenic patients who had been thymectomized. Histologically, the thymuses tested comprised three cases of thymoma including two cases with malignant characteristics, five cases of hyperplastic thymus with lymph follicles and germinal centres, and two cases of persistent thymus without lymph follicles. Virtually all lymphoid cells in the three thymomas formed spontaneous rosettes with sheep red blood cells as did normal thymocytes from non-myasthenic patients. There was no significant proportion of immunoglobulin Ig-bearing lymphocytes. While the majority consisted of cells forming spontaneous rosettes with sheep red blood cells, there was a certain proportion (2-17%) of Ig-bearing lymphocytes in four of five hyperplastic thymuses, in one of two persistent thymuses, and in a residual atrophic thymus of a thymoma. The myasthenic patients tested were for the most part normal, as compared with healthy individuals, in the proportion of rosette-forming lymphocytes and Ig-bearing lymphocytes in the blood collected immediately before and one to three months after thymectomy. The presence of Ig-bearing lymphocytes in the thymus was not necessarily related to the appearance of circulating antibody to striated muscle. The antibody to striated muscle was demonstrated in all myasthenic patients with thymoma.  (+info)

Anti-sense approach to anticholinesterase therapeutics. (45/830)

The acetylcholine-hydrolyzing enzyme, acetylcholinesterase, is the molecular target of approved drugs for Alzheimer's disease and myasthenia gravis. However, recent data implicate AChE splicing variants in the etiology of complex diseases such as AD and MG. Despite the large arsenal of anti-AChE drugs, therapeutic inhibitors are primarily targeted towards an active site shared by all variants. In contrast, anti-sense oligonucleotides attack unique mRNA sequences rather than tertiary protein structures. AS-ODNs thus offer a means to target gene expression in a highly discriminative manner using very low concentrations of drug. In light of the likely role(s) of specific AChE variants in various diseases affecting cholinergic neurotransmission, the potential contribution that anti-sense technology can make towards improved approaches to anti-AChE therapeutics deserves serious attention.  (+info)

Preanesthetic train-of-four fade predicts the atracurium requirement of myasthenia gravis patients. (46/830)

BACKGROUND: The most sensitive diagnostic criterion of myasthenia gravis is a decrement in the muscular response to repetitive stimulation. The authors hypothesized that myasthenia gravis patients who show a train-of-four ratio (T4/T1) < 0.9 in the preanesthetic period will have increased sensitivity to nondepolarizing neuromuscular blocking agents compared with myasthenia gravis patients with preanesthetic T4/T1 > or = 0.9. METHODS: After institutional review board approval was obtained, 20 electrophysiologically documented myasthenia gravis patients were studied. Current pyridostigmine therapy was continued until the morning of surgery. Before induction of anesthesia, neuromuscular transmission was recorded from the hypothenar muscles using electromyography with train-of-four stimulation of the ulnar nerve. According to the T4/T1 ratio, patients were assigned to the "normal" group (T4/T1 > or = 0.9) or the "decrement" group (T4/T1 < 0.9). After induction of intravenous anesthesia, the effective dose to achieve a 95% neuromuscular blockade (ED95) for atracurium was assessed with a cumulative bolus technique. Postoperatively, pyridostigmine was titrated to obtain a T4/T1 > 0.75 and to treat residual myasthenic symptoms. RESULTS: In 14 patients, preanesthetic T4/T1 was > or = 0.9 (normal), whereas 6 patients presented with T4/T1 < 0.9 (decrement). Decrement patients had a lower ED95 of 0.07 +/- 0.03 mg/kg atracurium (mean +/- SD) compared with normal patients with an ED95 of 0.24 +/- 0.11 mg/kg atracurium (P = 0.002). All patients were extubated within 30 min after surgery. Postoperative pyridostigmine infusion did not differ significantly between groups. CONCLUSIONS: The requirement for atracurium is significantly reduced in myasthenia gravis patients with a T4/T1 ratio < 0.9 before anesthesia. This study indicates that routine neuromuscular monitoring in myasthenia gravis patients should be extended into the preinduction period to identify patients who require less atracurium.  (+info)

Diseases associated with specific HL-A antigens. (47/830)

Significantly increased prevalences of particular HL-A antigens have been reported for many human diseases. The correlation is particularly striking in ankylosing spondylitis, Reiter's syndrome, psoriasis and some immunopathic disorders, so that HL-A typing may be of great value in diagnosis. The possible mechanisms whereby these associations may occur suggest the cause of certain disorders, and further investiatation will likely help in the understanding of the pathogenesis of many diseases.  (+info)

Coronary artery bypass surgery in a patient with myasthenia gravis. (48/830)

A 73-year-old man with myasthenia gravis required quadruple coronary artery bypass grafting due to triple-vessel disease. Anesthetic management was performed with general anesthesia using a reduced dose of muscle relaxant with the aid of a neuromuscular transmission monitor. He was extubated 14 hrs after surgery without difficulty under this monitor. His postoperative course was uneventful. A patient with myasthenia gravis who required coronary artery bypass surgery was successfully performed by the deliberate preoperative evaluation of patient's myasthenic and cardiac status, and by the careful perioperative management.  (+info)