PMID- 29301152
OWN - NLM
STAT- MEDLINE
DCOM- 20191008
LR  - 20191008
IS  - 1439-1899 (Electronic)
IS  - 0174-304X (Linking)
VI  - 49
IP  - 3
DP  - 2018 Jun
TI  - A 5-Year Follow-Up of Triple-Seronegative Myasthenia Gravis Successfully Treated 
      with Tacrolimus Therapy.
PG  - 200-203
LID - 10.1055/s-0037-1618591 [doi]
AB  - Seronegative myasthenia gravis (MG) is a generalized form of MG that is diagnosed 
      on the basis of clinical symptoms, electrophysiological testing, and 
      pharmacological responses, in the absence of a seropositive status for 
      anti-acetylcholine receptor (AChR) antibodies. Generalized MG that is 
      seronegative for anti-AChR, anti-muscle-specific kinase (MuSK), and anti-low 
      density lipoprotein receptor related protein 4 (Lrp4) antibodies is known as 
      triple-seronegative MG. We here describe a case of triple-seronegative MG in an 
      8-year-old boy. His first symptom was dysphagia, at 3 years of age, and he 
      subsequently developed ptosis, rhinolalia, and a waddling gait. A genetic 
      analysis was conducted to exclude the possibility of congenital myasthenia 
      syndrome due to the patient's resistance to steroid therapy. His condition was 
      successfully managed with tacrolimus therapy over a 5-year follow-up period. 
      Recently, several studies have reported the therapeutic utility of tacrolimus in 
      juvenile seropositive MG; in contrast, a few reports have described tacrolimus 
      treatment in cases of seronegative MG. Our findings suggest that tacrolimus 
      therapy is a safe and effective option for the treatment of juvenile seronegative 
      MG.
CI  - Georg Thieme Verlag KG Stuttgart . New York.
FAU - Tozawa, Takenori
AU  - Tozawa T
AD  - Department of Pediatrics, Ayabe City Hospital, Ayabe, Japan.
AD  - Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate 
      School of Medical Science, Kyoto, Japan.
FAU - Nishimura, Akira
AU  - Nishimura A
AD  - Department of Neonatology, Japanese Red Cross Society Kyoto Daiichi Hospital, 
      Kyoto, Japan.
FAU - Ueno, Tamaki
AU  - Ueno T
AD  - Department of Pediatrics, Ayabe City Hospital, Ayabe, Japan.
AD  - Department of Pediatrics, Tokai Central Hospital, Kakamigahara, Japan.
FAU - Kaneda, Daisuke
AU  - Kaneda D
AD  - Department of Pediatrics, Ayabe City Hospital, Ayabe, Japan.
AD  - Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate 
      School of Medical Science, Kyoto, Japan.
FAU - Miyanomae, Yuri
AU  - Miyanomae Y
AD  - Clinics of Kyoto City Child Well-being Center, Kyoto, Japan.
FAU - Chiyonobu, Tomohiro
AU  - Chiyonobu T
AD  - Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate 
      School of Medical Science, Kyoto, Japan.
FAU - Morimoto, Masafumi
AU  - Morimoto M
AD  - Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate 
      School of Medical Science, Kyoto, Japan.
FAU - Hosoi, Hajime
AU  - Hosoi H
AD  - Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate 
      School of Medical Science, Kyoto, Japan.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20180104
PL  - Germany
TA  - Neuropediatrics
JT  - Neuropediatrics
JID - 8101187
RN  - 0 (Immunosuppressive Agents)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Child
MH  - Follow-Up Studies
MH  - Humans
MH  - Immunosuppressive Agents/*therapeutic use
MH  - Male
MH  - Myasthenia Gravis/*drug therapy/genetics/physiopathology
MH  - Peripheral Nerves/drug effects/physiopathology
MH  - Tacrolimus/*therapeutic use
COIS- The authors indicated no potential conflict of interest.
EDAT- 2018/01/05 06:00
MHDA- 2019/10/09 06:00
CRDT- 2018/01/05 06:00
PHST- 2018/01/05 06:00 [pubmed]
PHST- 2019/10/09 06:00 [medline]
PHST- 2018/01/05 06:00 [entrez]
AID - 10.1055/s-0037-1618591 [doi]
PST - ppublish
SO  - Neuropediatrics. 2018 Jun;49(3):200-203. doi: 10.1055/s-0037-1618591. Epub 2018 
      Jan 4.