Myasthenia gravis is improved temporarily at postburn period

K. Uehara, Motomu Kobayashi, A. Hirasaki, Y. Asao, O. Kobayashi

Research output: Contribution to journalArticle

Abstract

A 62-year-old woman with a 25-year history of myasthenia gravis (MG) was admitted to our hospital due to burn injury over 20-25% of the total body surface area. Five months before admission, the serum concentration of acetylcholine receptor (AchR) antibodies was 80.9 nmol · l-1 (normal range-1). Anticholinesterase agents had been administered for MG, but were discontinued six days after admission due to muscarinic side effects, but no symptoms of MG appeared. Thirteen days after admission, the AchR antibody titer was 21.2 nmol · l-1. Free skin grafting was performed under general anesthesia without any event. About 80 days after admission, weakness of extraocular muscles appeared. Positive tensilon test and the characteristic electromyographic findings revealed deterioration of MG, and anticholinesterase agents were resumed. Ten months after admission, the AchR antibody titer was 50.4 nmol · l-1The mechanism of the temporary improvement of MG symptoms does not appear to be explained by the diffuse immunosuppression after burn. At a postburn period, nicotinic AchRs at the neuromuscular junction are known to be temporarily induced. This up-regulation may have caused the temporary improvement in this patient.

Original languageEnglish
Pages (from-to)521-524
Number of pages4
JournalJapanese Journal of Anesthesiology
Volume50
Issue number5
Publication statusPublished - 2001

Fingerprint

Myasthenia Gravis
Cholinergic Receptors
Cholinesterase Inhibitors
Antibodies
Oculomotor Muscles
Edrophonium
Skin Transplantation
Neuromuscular Junction
Body Surface Area
Immunosuppression
General Anesthesia
Cholinergic Agents
Reference Values
Up-Regulation
Wounds and Injuries
Serum

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Uehara, K., Kobayashi, M., Hirasaki, A., Asao, Y., & Kobayashi, O. (2001). Myasthenia gravis is improved temporarily at postburn period. Japanese Journal of Anesthesiology, 50(5), 521-524.

Myasthenia gravis is improved temporarily at postburn period. / Uehara, K.; Kobayashi, Motomu; Hirasaki, A.; Asao, Y.; Kobayashi, O.

In: Japanese Journal of Anesthesiology, Vol. 50, No. 5, 2001, p. 521-524.

Research output: Contribution to journalArticle

Uehara, K, Kobayashi, M, Hirasaki, A, Asao, Y & Kobayashi, O 2001, 'Myasthenia gravis is improved temporarily at postburn period', Japanese Journal of Anesthesiology, vol. 50, no. 5, pp. 521-524.
Uehara, K. ; Kobayashi, Motomu ; Hirasaki, A. ; Asao, Y. ; Kobayashi, O. / Myasthenia gravis is improved temporarily at postburn period. In: Japanese Journal of Anesthesiology. 2001 ; Vol. 50, No. 5. pp. 521-524.
@article{36ef17af233b44c088b5761894fdb65b,
title = "Myasthenia gravis is improved temporarily at postburn period",
abstract = "A 62-year-old woman with a 25-year history of myasthenia gravis (MG) was admitted to our hospital due to burn injury over 20-25{\%} of the total body surface area. Five months before admission, the serum concentration of acetylcholine receptor (AchR) antibodies was 80.9 nmol · l-1 (normal range-1). Anticholinesterase agents had been administered for MG, but were discontinued six days after admission due to muscarinic side effects, but no symptoms of MG appeared. Thirteen days after admission, the AchR antibody titer was 21.2 nmol · l-1. Free skin grafting was performed under general anesthesia without any event. About 80 days after admission, weakness of extraocular muscles appeared. Positive tensilon test and the characteristic electromyographic findings revealed deterioration of MG, and anticholinesterase agents were resumed. Ten months after admission, the AchR antibody titer was 50.4 nmol · l-1The mechanism of the temporary improvement of MG symptoms does not appear to be explained by the diffuse immunosuppression after burn. At a postburn period, nicotinic AchRs at the neuromuscular junction are known to be temporarily induced. This up-regulation may have caused the temporary improvement in this patient.",
author = "K. Uehara and Motomu Kobayashi and A. Hirasaki and Y. Asao and O. Kobayashi",
year = "2001",
language = "English",
volume = "50",
pages = "521--524",
journal = "Japanese Journal of Anesthesiology",
issn = "0021-4892",
publisher = "Kokuseido Publishing Co. Ltd",
number = "5",

}

TY - JOUR

T1 - Myasthenia gravis is improved temporarily at postburn period

AU - Uehara, K.

AU - Kobayashi, Motomu

AU - Hirasaki, A.

AU - Asao, Y.

AU - Kobayashi, O.

PY - 2001

Y1 - 2001

N2 - A 62-year-old woman with a 25-year history of myasthenia gravis (MG) was admitted to our hospital due to burn injury over 20-25% of the total body surface area. Five months before admission, the serum concentration of acetylcholine receptor (AchR) antibodies was 80.9 nmol · l-1 (normal range-1). Anticholinesterase agents had been administered for MG, but were discontinued six days after admission due to muscarinic side effects, but no symptoms of MG appeared. Thirteen days after admission, the AchR antibody titer was 21.2 nmol · l-1. Free skin grafting was performed under general anesthesia without any event. About 80 days after admission, weakness of extraocular muscles appeared. Positive tensilon test and the characteristic electromyographic findings revealed deterioration of MG, and anticholinesterase agents were resumed. Ten months after admission, the AchR antibody titer was 50.4 nmol · l-1The mechanism of the temporary improvement of MG symptoms does not appear to be explained by the diffuse immunosuppression after burn. At a postburn period, nicotinic AchRs at the neuromuscular junction are known to be temporarily induced. This up-regulation may have caused the temporary improvement in this patient.

AB - A 62-year-old woman with a 25-year history of myasthenia gravis (MG) was admitted to our hospital due to burn injury over 20-25% of the total body surface area. Five months before admission, the serum concentration of acetylcholine receptor (AchR) antibodies was 80.9 nmol · l-1 (normal range-1). Anticholinesterase agents had been administered for MG, but were discontinued six days after admission due to muscarinic side effects, but no symptoms of MG appeared. Thirteen days after admission, the AchR antibody titer was 21.2 nmol · l-1. Free skin grafting was performed under general anesthesia without any event. About 80 days after admission, weakness of extraocular muscles appeared. Positive tensilon test and the characteristic electromyographic findings revealed deterioration of MG, and anticholinesterase agents were resumed. Ten months after admission, the AchR antibody titer was 50.4 nmol · l-1The mechanism of the temporary improvement of MG symptoms does not appear to be explained by the diffuse immunosuppression after burn. At a postburn period, nicotinic AchRs at the neuromuscular junction are known to be temporarily induced. This up-regulation may have caused the temporary improvement in this patient.

UR - http://www.scopus.com/inward/record.url?scp=0034992857&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034992857&partnerID=8YFLogxK

M3 - Article

C2 - 11424470

AN - SCOPUS:0034992857

VL - 50

SP - 521

EP - 524

JO - Japanese Journal of Anesthesiology

JF - Japanese Journal of Anesthesiology

SN - 0021-4892

IS - 5

ER -