Miastenia gravis: a propósito de uma caso clínico

Autores

  • Paula Vaz Marques Interna do Internato Complementar de Medicina Interna, Serviço de Medicina 1 do Hospital de São João, Porto

Palavras-chave:

acetilcolina, autoimune, miastenia gravis

Resumo

A miastenia gravis é uma doença autoimune da
junção neuromuscular na qual se verifica a produção
de anticorpos dirigidos contra os receptores
nicotínicos da acetilcolina, localizados na membrana
pós-sináptica. Esse ataque autoimune traduz-se,
clinicamente, por fraqueza muscular com
predomínio bulbar e fadiga com actividade muscular repetida.
Os autores, a propósito de um caso clínico,
discutem a etiopatogenia, manifestações clínicas,
diagnóstico e opções terapêuticas na miastenia gravis.

Downloads

Não há dados estatísticos.

Referências

Drachman DB. Myasthenia gravis. N Engl J Med 1994;330:1797-1810.

Drachman DB. Myasthenia gravis and other diseases of neuromuscular junction. Fauci AS et al, Harrison‘s principles of Internal Medicine, New York, McGraw-Hill, 1998, 2469-2472.

Dalakas MC. Disorders of neuromuscular transmission. Dale DC, Federman DD. Scientific American Medicine. New York, Scientific

American Medicine Inc., 1999.

Castleman B. The patology of the thymus gland in myasthenia gravis: Ann N Y Acad Sci 1966;135:496-505.

Buckingham JM, Howard FM Jr, Bernatz PE, et al. The value of thymectomy in myasthenia gravis: a computer-assisted matched

study. Ann Surg 1976;184:453-458.

Wekerle H, Paterson B, Ketelsen U-P, Feldman M. Striated muscle fibers differentiate in monolayer cultures of adult thymus reticulum.

Nature 1975;256:493-494.

Kao I. Drachman DB. Thymic muscle cells bear acethylcoline receptors: possible relation to myasthenia gravis. Science

;195:74-75.

Kirchner T, Hoppe F, Schalke B, Muller-Hermelink HK. Microenvironment of thymic myoid cells in myasthenia gravis. Virchows Arch [B] Cell Pathol 1988;54:295-302.

Stefansson K, Dieperink ME, Richman DP, Gomez CM, Marton LS. Shering of antigenic determinants between the nicotinic acetylcholine receptor and proteins in Escherichia coli, Proteus vulgaris and Klebsiella pneumoniae: Possible role in the patogenesis of myasthenia gravis. N Engl J Med 1985;312:221-225.

Aoki T, Drachman DB, Asher DM, Gibbs CJ Jr, Bahmanyar S, Wolinsky JS. Attempts to implicate viruses in myasthenia gravis.

Neurology 1985;35:185-192.

Lindstrom JM, Seybold ME, Lennon VA, Whittingham S, Duane DD. Antibody to achetylcoline receptor in myasthenia gravis: prevalence, clinical correlates and diagnostic value. Neurology 1976;26:1054-1059.

Drachman DB, Adams RN, Josifek LF, Self SG. Functional activities of autoantibodies to acetylcholine receptors and the clinical

severity of myasthenia gravis. N Engl J Med 1982;307:769-775.

Vincent A, Newsom-Davis J. Acetylcholine receptor antibody as a diagnostic test for myasthenia gravis: results in 153 validated

cases and 2967 diagnostic assays. J Neurol Neurosurg Psychiatry 1985;48:1246-1252.

Howard FM Jr, Lennon VA, Finley J, Matsumoto J, Elveback LR. Clinical correlations of antibodies that bind, block, or modulate

human acetylcholine receptors in myasthenia gravis. Ann N Y Acad Sci 1987;505:526-538.

Fambrough DM, Drachman DB, Satyamurti S. Neuromuscular junctio in myasthenia gravis: decreased acetylcholine receptors.

Science 1973;182:293-295.

Engel AG, Tsugihata M, Lindstrom JM, Lennon VA. The motor end plate in myasthenia gravis and in experimental autoimmune

myasthenia gravis: a quantitative ultrastructural study. Ann N Y Acad Sci 1976;274:60-79.

Pestronk A, Drachman DB, Self SG. Mesurement of junctional acetylcholine receptors in myasthenia gravis: clinical correlates.

Muscle Nerve 1985; 8:245-251.

Grob D, Arsura EL, Brunner NG, Namba T. The course of myasthenia gravis and therapies affecting outcome. Ann N Y

Acad Sci 1987;505:472-499.

Osserman KE. Myasthenia gravis. New York: Grune & Stratton, 1958:80.

Willis T. De anima brutorum. Oxford, England: Theatro Sheldoniano 1672:404-406.

Keesey JC. Electrodiagnostic approach to defects of neuromuscular transmission. Muscle Nerve 1989;12:613-626.

Stalberg E, Trontelj J. Single fiber electromyigraphy. Old Working, England: Mirvalle Press, 1979.

Oh SJ, Kim DE, Kuruoglu R, Bradley RJ, Dwyer D. Diagnostis sensitivity of the laboratory tests in myasthenia gravis. Muscle

Nerve 1992;15:720-724.

Scully RE, Mark EJ, McNeely WF, Ebeling SH, Phillips LD, Ellender SM. Case Records of the Massachusets General Hospital.

N Engl J Med 2000;342:1508-1514

Lanska DJ. Indications for thymectomy in myasthenia gravis. Neurology 1990;40:1828-1829.

Seybold ME, Howard FM Jr, Duane DD, Payne WS, Harrison EG Jr. Thymectomy in juvenile myasthenia gravis. Arch Neurol

;25:385-392.

Tindall RS. Humoral immunity in myasthenia gravis: effects of steroids and thymectomy. Neurology 1980;30:554-55 7.

Abramsky O, Aharonov A, Teitelbaum D, Fuchs S. Myasthenia gravis and acetylcholine receptor: effect of steroids in clinical

course and cellular immune response to acetylcholine receptor. Arch Neurol 1975;32:684-687.

Kaplan I, Blakely BT, Pavlath GK, Travis M, Blau HM. Steroids induce acetylcholine receptors on cultured human muscle:

implications for myasthenia gravis. Proc Natl Acad sci U S A 1990;87:8100-8104.

Van Wilgenburg H. The effect of prednisolone on neuromuscular transmission in the rat diaphragm. Eur J Pharmacol 1979;55:355-

Jonhs TR. Long-term corticosteroid treatment of myasthenia gravis. Ann N Y Acad Sci 1987;505:568-583.

Arsura E. Experience with intravenous immunoglobuline in myasthenia gravis. Clin Immunol Immunopathol 1989;53: S170-

S179

Ficheiros Adicionais

Publicado

30-03-2001

Como Citar

1.
Vaz Marques P. Miastenia gravis: a propósito de uma caso clínico. RPMI [Internet]. 30 de Março de 2001 [citado 6 de Dezembro de 2024];8(1):23-7. Disponível em: https://revista.spmi.pt/index.php/rpmi/article/view/1892

Edição

Secção

Casos Clínicos