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Myasthenia Gravis

Myasthenia Gravis. MyAsthenia Gravis. Muscle. Weakness. Severe. Immunized Rabbits Experiment. What Happens????. What type of immunoglobulin is involved????. IgG. The Case of MR.WELD. -71 year old male -Good health -active for whole life. Diplopia for 4 months. Ptosis in both eyes.

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Myasthenia Gravis

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  1. Myasthenia Gravis

  2. MyAsthenia Gravis Muscle Weakness Severe

  3. Immunized Rabbits Experiment

  4. What Happens????

  5. What type of immunoglobulin is involved???? IgG

  6. The Case of MR.WELD

  7. -71 year old male -Good health-active for whole life

  8. Diplopia for 4 months

  9. Ptosis in both eyes

  10. Ocular movement limitation

  11. Remainder of neurological examination was normal • No other muscle weakness was found • Radiological examination of the chest was normal • No evidence of enlarged thymus---- different in younger people?????

  12. Blood serum contained 6.8 units of antibody to the acetylcholine receptor (normal<.5)

  13. He was told to take pyridostigmine inhibitor of cholinesterase

  14. Three years later…… Developed a severe respiratory infection…breaking tolerance

  15. Ptosis became so severe he had to tape his eye lids to keep eyes open

  16. Diplopia recurred. • Speech became indistinct…..weakness of facial muscles and tongue. • Abnormality in ocular movements became apparent again. • Difficulty in chewing and swallowing food….diet of only soft food • He could only tolerate a quarter of recommended dose of pyridostigmine. • Difficulty in breathing….vital capacity = 3.5 liters.

  17. Treated with azathioprine…immunosupressive agent

  18. Mr.weld is better!

  19. Finally done!!!

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