PMID- 26376969
OWN - NLM
STAT- MEDLINE
DCOM- 20151222
LR  - 20220410
IS  - 1474-4465 (Electronic)
IS  - 1474-4422 (Linking)
VI  - 14
IP  - 10
DP  - 2015 Oct
TI  - Myasthenia gravis: subgroup classification and therapeutic strategies.
PG  - 1023-36
LID - S1474-4422(15)00145-3 [pii]
LID - 10.1016/S1474-4422(15)00145-3 [doi]
AB  - Myasthenia gravis is an autoimmune disease that is characterised by muscle 
      weakness and fatigue, is B-cell mediated, and is associated with antibodies 
      directed against the acetylcholine receptor, muscle-specific kinase (MUSK), 
      lipoprotein-related protein 4 (LRP4), or agrin in the postsynaptic membrane at 
      the neuromuscular junction. Patients with myasthenia gravis should be classified 
      into subgroups to help with therapeutic decisions and prognosis. Subgroups based 
      on serum antibodies and clinical features include early-onset, late-onset, 
      thymoma, MUSK, LRP4, antibody-negative, and ocular forms of myasthenia gravis. 
      Agrin-associated myasthenia gravis might emerge as a new entity. The prognosis is 
      good with optimum symptomatic, immunosuppressive, and supportive treatment. 
      Pyridostigmine is the preferred symptomatic treatment, and for patients who do 
      not adequately respond to symptomatic therapy, corticosteroids, azathioprine, and 
      thymectomy are first-line immunosuppressive treatments. Additional 
      immunomodulatory drugs are emerging, but therapeutic decisions are hampered by 
      the scarcity of controlled studies. Long-term drug treatment is essential for 
      most patients and must be tailored to the particular form of myasthenia gravis.
CI  - Copyright (c) 2015 Elsevier Ltd. All rights reserved.
FAU - Gilhus, Nils Erik
AU  - Gilhus NE
AD  - Department of Clinical Medicine, University of Bergen, Bergen, Norway; Department 
      of Neurology, Haukeland University Hospital, Bergen, Norway. Electronic address: 
      nils.gilhus@helse-bergen.no.
FAU - Verschuuren, Jan J
AU  - Verschuuren JJ
AD  - Department of Neurology, Leiden University Medical Center, Leiden, Netherlands.
LA  - eng
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - England
TA  - Lancet Neurol
JT  - The Lancet. Neurology
JID - 101139309
SB  - IM
CIN - Lancet Neurol. 2016 Apr;15(4):355-6. PMID: 26971654
CIN - Lancet Neurol. 2016 Apr;15(4):356-7. PMID: 26971655
CIN - Lancet Neurol. 2016 Apr;15(4):357-8. PMID: 26971656
MH  - Humans
MH  - *Myasthenia Gravis/classification/drug therapy/immunology
EDAT- 2015/09/18 06:00
MHDA- 2015/12/23 06:00
CRDT- 2015/09/18 06:00
PHST- 2014/07/30 00:00 [received]
PHST- 2015/06/02 00:00 [revised]
PHST- 2015/06/19 00:00 [accepted]
PHST- 2015/09/18 06:00 [entrez]
PHST- 2015/09/18 06:00 [pubmed]
PHST- 2015/12/23 06:00 [medline]
AID - S1474-4422(15)00145-3 [pii]
AID - 10.1016/S1474-4422(15)00145-3 [doi]
PST - ppublish
SO  - Lancet Neurol. 2015 Oct;14(10):1023-36. doi: 10.1016/S1474-4422(15)00145-3.