PMID- 28079665
OWN - NLM
STAT- MEDLINE
DCOM- 20170322
LR  - 20181202
IS  - 2325-7237 (Electronic)
IS  - 2325-7237 (Linking)
VI  - 8
IP  - 6
DP  - 2017 Mar 15
TI  - Anesthetic Management of a Patient With Antimuscle-Specific Kinase 
      Antibody-Positive Myasthenia Gravis Undergoing an Open Cholecystectomy: A Case 
      Report.
PG  - 150-153
LID - 10.1213/XAA.0000000000000453 [doi]
AB  - Myasthenia gravis (MG) is an autoimmune disease characterized by the production 
      of antibodies against the acetylcholine receptor, muscle-specific kinase (MuSK), 
      or other proteins at the neuromuscular junction. MG with antibodies against MuSK 
      (MuSK-MG) has been described recently. Here, we report the first case of 
      anesthetic management of a patient with MuSK-MG undergoing an open 
      cholecystectomy. In our case, propofol and remifentanil-based anesthesia were 
      used for successful management without using muscle relaxants. Patients with 
      MuSK-MG have predominantly ocular, bulbar, and respiratory symptoms that may 
      increase the risk of aspiration. Anesthesiologists need to pay attention to 
      perioperative respiratory failure and respiratory crisis.
FAU - Akatsu, Masahiko
AU  - Akatsu M
AD  - From the *Department of Anesthesiology, Iwaki Kyoritsu Hospital, Fukushima, 
      Japan; daggerDepartment of Disaster and Comprehensive Medicine, Fukushima Medical 
      University, Fukushima, Japan; double daggerDepartment of Anesthesiology, Fukushima Medical 
      University School of Medicine, Fukushima, Japan; and  section signDepartment of Emergency and 
      Critical Care Medicine, Fukushima Medical University, Fukushima, Japan.
FAU - Ikegami, Yukihiro
AU  - Ikegami Y
FAU - Tase, Choichiro
AU  - Tase C
FAU - Nishikawa, Koichi
AU  - Nishikawa K
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - A A Case Rep
JT  - A & A case reports
JID - 101637720
RN  - 0 (Anesthetics, Intravenous)
RN  - 0 (Autoantibodies)
RN  - 0 (Piperidines)
RN  - 0 (Receptors, Cholinergic)
RN  - EC 2.7.10.1 (MUSK protein, human)
RN  - EC 2.7.10.1 (Receptor Protein-Tyrosine Kinases)
RN  - P10582JYYK (Remifentanil)
RN  - YI7VU623SF (Propofol)
SB  - IM
MH  - Analgesia, Epidural/methods
MH  - Anesthesia, General/*methods
MH  - Anesthetics, Intravenous/*therapeutic use
MH  - Autoantibodies/*immunology
MH  - Cholecystectomy/methods
MH  - Cholecystitis/complications/surgery
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Myasthenia Gravis/complications/*immunology
MH  - Pain, Postoperative/drug therapy/prevention & control
MH  - Piperidines/*therapeutic use
MH  - Propofol/*therapeutic use
MH  - Receptor Protein-Tyrosine Kinases/*immunology
MH  - Receptors, Cholinergic/*immunology
MH  - Remifentanil
EDAT- 2017/01/13 06:00
MHDA- 2017/03/23 06:00
CRDT- 2017/01/13 06:00
PHST- 2017/01/13 06:00 [pubmed]
PHST- 2017/03/23 06:00 [medline]
PHST- 2017/01/13 06:00 [entrez]
AID - 10.1213/XAA.0000000000000453 [doi]
PST - ppublish
SO  - A A Case Rep. 2017 Mar 15;8(6):150-153. doi: 10.1213/XAA.0000000000000453.