Lu sur :https://www.ncbi.nlm.nih.gov/pubmed/29790193
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Myasthenic ophthalmoparesis: Time to resolution after initiating immune therapies.
Europa TA1, Nel M1, Heckmann JM1.
Muscle Nerve. 2018 May 23. doi: 10.1002/mus.26172. [Epub ahead of print]
Abstract
- INTRODUCTION:
Although immunotherapies such as prednisone are effective in treating myasthenic muscle weakness, their effect on resolution of myasthenic-induced persistent ophthalmoparesis is unknown.
- METHODS:
We observed myasthenia gravis patients during their first year of immunotherapy, documenting ophthalmoplegia scores and drug doses.
- RESULTS:
Seventy-six of 87 cases had persistent ophthalmoparesis. On immunotherapy, the median time to resolution of ophthalmoparesis was 7 months and 37% resolved within 3 months. Those starting therapy within 12 months of symptom onset were twice as likely to have resolution in the first year (p=0.028). Resolution of ophthalmoparesis within 3 months, compared to later, was associated with higher initial prednisone doses (mean 0.5 vs. 0.3 mg/kg/day; p = 0.014). However, 25% of the higher-dose group also received intravenous immunoglobulin/plasma exchange; after their exclusion the finding was not significant.
DISCUSSION:
A third of cases with myasthenic-ophthalmoparesis resolved within 3 months of immunotherapy, particularly in response to more aggressive immunotherapy.
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