Última revisão: 29 Out 2021
Última atualização: 01 Abr 2021

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • fatigabilidade muscular
  • ptose
  • diplopia
  • disfagia
  • disartria
  • paresia facial
  • fraqueza muscular proximal
  • dispneia

Fatores de risco

  • história familiar de distúrbios autoimunes
  • marcadores genéticos
  • terapia dirigida ao câncer

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • análise de anticorpo sérico antirreceptor da acetilcolina (AchR)
  • anticorpos antitirosina quinase músculo-específica (MuSK)
  • testes seriados de função pulmonar

Investigações a serem consideradas

  • testes de anticorpos antirreceptor de músculo estriado
  • estimulação nervosa repetitiva
  • eletromiografia (EMG) de fibra única
  • tomografia computadorizada (TC) do tórax

Algoritmo de tratamento

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

Declarações

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.

Agradecimentos

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

Vern C. Juel, MD

Associate Professor of Medicine (Neurology)

Duke University

Durham

NC

Declarações

VCJ declares that he has no competing interests.

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