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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Seronegative myasthenic crisis: a multicenter analysis.

Philipp Mergenthaler1,2,3, Henning R Stetefeld4, Christian Dohmen4,5

  • 1Charité - Universitätsmedizin Berlin, Department of Neurology with Experimental Neurology, Neuroscience Clinical Research Center, Berlin, Germany.

Journal of Neurology
|April 7, 2022
PubMed
Summary
This summary is machine-generated.

Myasthenic crisis (MC) in seronegative myasthenia gravis (MG) patients occurs in younger individuals after a longer disease duration. However, outcomes and treatment efficacy for seronegative MCs are comparable to those with acetylcholine-receptor-antibody-positive MG.

Keywords:
Antibody statusMyasthenia gravisMyasthenic crisisOutcomeSeronegative

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Area of Science:

  • Neurology
  • Immunology
  • Clinical Medicine

Background:

  • Myasthenic crisis (MC) is a severe, life-threatening exacerbation in myasthenia gravis (MG) patients.
  • Seronegative MG accounts for 10-15% of all MG cases, yet outcomes during MC are understudied.
  • Understanding seronegative MC is crucial for comprehensive MG management.

Purpose of the Study:

  • To compare the clinical characteristics and outcomes of myasthenic crisis in seronegative MG versus acetylcholine-receptor-antibody-positive MG (AChR-MG).
  • To analyze differences in patient demographics, disease course, and treatment response between the two groups.

Main Methods:

  • Retrospective multicenter study in Germany (2006-2015).
  • Subgroup analysis of patients experiencing MC, comparing seronegative MG (n=15) with AChR-MG (n=142).
  • Data collected on demographics, disease duration, thymus status, and critical care parameters.

Main Results:

  • Seronegative MC patients were younger (54.3 vs. 66.5 years) and had a higher rate of thymus hyperplasia (29.4% vs. 3.1%).
  • The time from MG diagnosis to MC was significantly longer in seronegative patients (8.2 vs. 3.1 years).
  • No significant differences were observed in mechanical ventilation duration, ICU length of stay, or in-hospital mortality between groups.

Conclusions:

  • Myasthenic crisis in seronegative MG predominantly affects younger patients and occurs later in the disease course.
  • Despite demographic and disease course differences, the efficacy of crisis management and patient outcomes are similar for seronegative and AChR-MG patients.
  • These findings highlight the importance of considering seronegative MG in MC management protocols.