PubMed Health⌕ Search

Biomedical subjects

A Evoli

Publications and source records attributed to A Evoli.

63 records · Page 4Linked to original sources
PubMed1983

Myasthenia gravis in the elderly: report of 37 cases.

The treatment of myasthenia gravis in the elderly is controversial. Thirty-seven myasthenic patients with onset of the disease after the age of 60 were followed for a period of 14 years. All of the 37 patients received anticholinesterase drugs during this period, ten underwent thymectomy, and 24 were treated with corticosteroids. At present, one patient is in remission, 28 are improved, one is unchanged, and seven have died. Only one death was directly related to myasthenia. In the authors' experience thymectomy can be an effective treatment of myasthenia gravis in elderly patients; corticosteroid therapy can also be useful in addition to or as an alternative to surgery. Using a "personalized" schedule the authors obtained good results in 78 per cent of their patients.

Aged↗
PubMed1980

Myasthenia gravis, thymectomy, and antiacetycholine receptor antibody.

The antiacetylcholine receptor antibody was titered in the serum of 63 patients with myasthenia gravis (MG) and 20 control healthy subjects. The titer was significantly high in 92% of MG patients in contrast with none of the controls and no correlation was found with the thymus pathology and the severity of the disease. The titer decreased after thymectomy almost steadily with the improvement of the myasthenic signs. The role of the antibody in the pathogenesis of the disease is discussed.

Acetylcholine↗
PubMed1979

Treatment of myasthenia gravis. Report on 139 patients.

In the treatment of myasthenia gravis (MG) considerable progress has recently been achieved. Our experience is based on the observation of 139 patients with an average follow-up of 3 years and 4 months. A treatment plan and results are presented. Indications for thymectomy: all cases of MG in adult life, apart from ocular myasthenia without radiological thymoma and without electrophysiological and pharmacological signs of generalization; before puberty only cases with radiological thymoma and severely incapacitating or life-threatening signs. Median sternotomy is preferable for thymoma, the transcervical approach with a sternal split for non-neoplastic thymus. Mediastinal radiotherapy is indicated after removal of an invasive or adhesive thymoma. Indications for corticosteroids: 1) before thymectomy: respiratory weakness; 2) soon after thymectomy: life-threatening signs; 3) later after thymectomy: incapacitating or life-threatening signs; 4) as an alternative to thymectomy: when surgery cannot be performed or it is not indicated. Oral Prednisone was nearly always preferred: alternate-day high single dose (75 to 115 mg) has given good results in most cases even if in some cases a small dose was required in the "off day"; inversely a lower alternate-day or daily dose was often sufficient. Long-term results: following this schedule for adult patients good results were scored in 67% of thymomas, in 94% of hyperplasias, and in 62% of unthymectomized patients: in prepuberal life the few cases of severe MG have all shown a favorable evolution.

Adrenal Cortex Hormones↗
PubMed1979

Subpopulations of T lymphocytes in myasthenia gravis patients.

Subpopulations of human peripheral blood T lymphocytes were examined in twenty-three myasthenic patients. T lymphocytes bearing receptors for the Fc portion of IgG (T gamma) were significantly increased in a third of the patients examined. T lymphocytes bearing receptors for the Fc portion of IgM (Tmu) were within normal values in all but two patients. Possible implications of these cells in the pathogenesis of myasthenia gravis are discussed.

Adolescent↗
PubMedDate not supplied

Association of myasthenia gravis and antisynthetase syndrome: a case report.

Myasthenia gravis is a chronic disease of neuromuscular transmission caused by loss of acetylcholine receptors. It can be found in association with other autoimmune disorders. We report the case of a 47-yr-old woman affected by Myasthenia gravis who complained of fever, progressive weakness of proximal limb muscle, arthritis and Raynauds phenomenon and dyspnea. Chest X-rays and CT scan showed an interstitial lung disease; laboratory data indicated an inflammatory picture and increased serum muscle enzymes. Evaluation for infectious, metabolic, iatrogenic and neoplastic aetiologies was unrevealing. The patients clinical condition together with positive results on antisynthetase antibody assay lead to the diagnosis of antisynthetase syndrome. To our knowledge, this is the first report on the association of Myasthenia gravis with antisynthetase syndrome.

Anti-Inflammatory Agents↗
PubMedDate not supplied

Somatosensory evoked potentials in the diagnosis of cervical spondylotic myelopathy.

Median, ulnar, radial and common peroneal nerve somatosensory evoked potentials (SEPs) were studied in 17 patients suffering from cervical spondylotic myelopathy. Median, ulnar and common peroneal nerve SEPs were abnormal in 41%, 71% and 100% of cases respectively. Abnormalities of the scalp far-field P14 evoked by upper limb stimulation correlated with joint and touch sensation impairment, but not with radiological findings. Therefore, P14 may be a reliable marker of dorsal column impairment in cervical spondylotic myelopathy. The analysis of the cervical N13 response, which was recorded using a cephalic reference electrode, did not give any further information. Common peroneal nerve SEP abnormalities were found in all our patients, but they were obviously of no value in identifying the cervical spine as the site of lesion.

Adult↗
PubMedDate not supplied

Circulating CD4+CD25+ T regulatory and natural killer T cells in patients with myasthenia gravis: a flow cytometry study.

The number of circulating CD4+ T cells constitutively expressing CD25 (T regulatory, Treg) and natural killer T (NK T) cells, the two major lymphocyte populations that help to maintain immune homeostasis, was studied in 22 unselected myasthenia gravis (MG) patients, 16 healthy subjects and 24 patients with cancer, the latter as a disease model of a relative immune suppression status. Treg cells were assessed according to their intermediate or high level of expression of CD25, i.e., CD25int and CD25bright, and to the expression of HLA-DR, CD62L, CD45RO and CD152. There were no differences in the number of NK T cells and CD4+CD25bright cells among the three series of individuals. MG patients and healthy subjects had also similar numbers of CD4+CD25int cells. However, the whole CD4+ cell compartment in MG patients was in an activated status, as indicated by the higher level of expression of CD152. By contrast, and consistent with a relative immune suppression status, cancer patients had higher numbers of CD4+CD25int cells and larger proportions of HLA-DR expressing CD4+CD25int and CD4+CD25bright cells. Immunomagnetically purified CD4+CD25+ cells from MG, healthy subjects and cancer patients were anergic and suppressed the proliferative response of other T cells.

Adolescent↗
PubMedDate not supplied

Myasthenia gravis and thymic Hodgkin's disease associated in one patient with familial lymphoproliferative disorders.

A 38-year-old man affected with generalized myasthenia gravis (MG) was submitted to thymectomy. At surgery thymic Hodgkin's disease (granulomatous thymoma) and an area of thymic hyperplasia were found. Subsequently, after treatment with anticholinesterase and corticosteroids, the patient achieved clinical remission. The development of MG in this patient could be related to the presence of thymic hyperplasia, rather than to the granulomatous thymoma. Family history revealed that a brother of the patient was affected by non-Hodgkin T-cell lymphoma. Human leukocyte antigens (HLA) were identical in the two affected siblings. The present report suggests a possible link between MG and lymphoproliferative disorders whose mechanism still needs to be clarified.

Adult↗