Última revisión: 26 Ago 2021
Última actualización: 01 Abril 2021

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • fatigabilidad muscular
  • ptosis
  • diplopía
  • disfagia
  • disartría
  • paresia facial
  • debilidad en las extremidades proximales
  • disnea

Factores de riesgo

  • antecedentes familiares de trastornos autoinmunes
  • marcadores genéticos
  • tratamiento dirigido contra el cáncer

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • análisis sérico de anticuerpos frente a los receptores de acetilcolina (AChR)
  • anticuerpos frente a la tirosina cinasa específica del músculo (MuSK)
  • pruebas funcionales respiratorias en serie

Pruebas diagnósticas que deben considerarse

  • ensayos de anticuerpos contra el receptor estriado
  • estimulación nerviosa repetitiva
  • electromiograma (EMG) de fibra aislada
  • tomografía computarizada (TC) de tórax

Algoritmo de tratamiento

Colaboradores

Autores

Robert P. Lisak, MD, FRCP (E), FAAN, FANA

Parker Webber Chair in Neurology

Professor of Neurology

Professor of Immunology and Microbiology

Wayne State University School of Medicine

Detroit

MI

Divulgaciones

RPL is an Advisory Board member for Argenx (developing a clinical trial for chronic inflammatory demyelinating polyneuropathy [CIDP]). RPL has worked with Alexion (testing a treatment for myasthenia gravis); Novartis (design of research related to primary progressive MS vs. secondary progressive MS); GLG Consulting, Putnam Consulting, Slingshot Consulting, Haven Consulting, Clearview Consulting, Alpha Sites Consulting, and Insights Consulting (providing insights on the current and future treatments of several neuroimmunologic diseases including MS, MG, Guillain-Barré syndrome, CIDP, and neuromyelitis optica spectrum disorder); and Teva Pharmaceuticals (two non-branded talks to patient groups about MS). RPL has presented several CME talks for companies with multiple sources of support (no direct payments to RBL). RPL has received clinical trial grants (no direct payments) for studies in myasthenia gravis (Alexion, Argenx, Ra Pharmaceuticals) and MS (Novartis, Teva, Genentech/Roche, Chugai). He has received royalties from Blackwell Press as an editors of a textbook International Neurology. RBL is an author of several papers cited in this topic.

Agradecimientos

Dr Robert Lisak would like to gratefully acknowledge Dr Andrea Corse and Dr Ami Mankodi, previous contributors to this topic. AC and AM declare that they have no competing interests.

Revisores por pares

Vern C. Juel, MD

Associate Professor of Medicine (Neurology)

Duke University

Durham

NC

Divulgaciones

VCJ declares that he has no competing interests.

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