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Gut microbiota composition across clinical subtype and antibody burden in myasthenia gravis.

BACKGROUND: Myasthenia gravis (MG) exhibits clinical heterogeneity ranging from ocular to generalized forms. Although gut microbiota has been implicated in autoimmune diseases, its relationship with clinical subtype and antibody burden in MG remains unclear. METHODS: We conducted a cross-sectional study of fecal microbiota in 14 patients with MG (3 ocular and 11 generalized) and 10 healthy controls using 16S rRNA sequencing. Patients with MG were stratified according to acetylcholine receptor antibody (AChR-Ab) titers into low (n = 5), moderate (n = 5), and high (n = 4) groups. RESULTS: Alph…

Unlocking the Potential of Isatin Scaffolds in Acetylcholinesterase Inhibition.

The therapeutic significance of acetylcholinesterase (AChE) inhibition is most prominently observed in the management of various neurodegenerative and neuromuscular disorders, including Alzheimer's disease (AD), and myasthenia gravis (MG). The present review examines isatin-based compounds as a promising class of drugs for treating these conditions, focusing on their ability to inhibit AChE. While AD is characterized by a significant loss of cholinergic neurons leading to a deficiency in acetylcholine (ACh), MG is an autoimmune disease where the body produces antibodies that block or destroy A…

A Case Report of Juvenile Myasthenia Gravis; Misdiagnosis and Considerations.

Juvenile myasthenia gravis (JMG) is a rare autoimmune disease acquired in childhood, comprising 8%-15% of all myasthenia gravis cases depending on geographic and ethnic populations. Ocular myasthenia gravis presents as ptosis with extraocular movement restriction and is frequently misdiagnosed as third nerve palsy or congenital ptosis when bilateral. Early diagnosis prevents disease progression and unnecessary interventions. We report a case of JMG initially misdiagnosed as Guillain-Barré syndrome (GBS) to highlight diagnostic pitfalls. A 4-year-old girl presented with left eye ptosis, followe…

Clinical Outcomes and Treatment Efficacy in Juvenile Myasthenia Gravis: A Retrospective Review From a Single Center.

INTRODUCTION/AIMS: Early recognition and treatment are critical in juvenile myasthenia gravis (JMG), yet pediatric-specific evidence remains limited. We aimed to describe treatment patterns, remission rates, and predictors in a Canadian cohort. METHODS: We conducted a retrospective study of patients under 18 years diagnosed with JMG at The Hospital for Sick Children, Toronto, between 2015 and 2025. Clinical, treatment, and outcome data were collected. Diagnosis was confirmed by antibody positivity or electrophysiology, and outcomes were classified using the Myasthenia Gravis Foundation of Ame…

Decrement on Low-Frequency Repetitive Nerve Stimulation Is Not Synonymous With Myasthenia Gravis.

Lambert-Eaton myasthenic syndrome (LEMS) is a rare presynaptic neuromuscular junction disorder that may be mistaken for peripheral neuropathy, radiculopathy, inflammatory myopathy, or myasthenia gravis. We report a female in her early 40s with two months of progressive, predominantly proximal lower-limb weakness, areflexia, and dry mouth, without ocular or bulbar symptoms. Routine laboratory testing and creatine kinase were unremarkable, while spinal imaging showed degenerative abnormalities that did not explain the clinical pattern. Nerve conduction studies demonstrated low compound muscle ac…

A case report of sequential efgartigimod and rituximab treatment for tSNMG.

Trible-seronegative myasthenia gravis (tSNMG) is defined as myasthenia gravis (MG) without detectable or low affinity antibodies to acetylcholine receptor (AChR), muscle-specific kinase (MuSK) andlipoprotein related protein 4(LRP-4). This article reports a case of a 39-year-old married female patient with thymoma-associated seronegative myasthenia gravis (tSNMG), which was accompanied by multiple positive autoantibodies and a benign mediastinal lesion. The primary manifestation was generalized muscle weakness, involving the limbs, bulbar muscles, and respiratory muscles. After admission, the p…

Effectiveness and safety of telitacicept in refractory ocular myasthenia gravis: a retrospective, real-world study.

INTRODUCTION: Refractory ocular myasthenia gravis (OMG) remains a significant therapeutic challenge with limited evidence-based biologic therapies. This study aimed to evaluate the effectiveness and safety of telitacicept, a recombinant B-lymphocyte stimulator receptor-antibody fusion protein, in refractory OMG. METHODS: This retrospective, single-center observational study assessed clinical outcomes, immunological biomarkers, and safety following add-on telitacicept therapy in refractory OMG. Disease severity was evaluated using the Myasthenia Gravis Activities of Daily Living (MG-ADL), Quan…

Efgartigimod-alfa therapy in acetylcholine receptor antibody myasthenia gravis: Romanian experience.

BACKGROUND: Efgartigimod alfa, the first neonatal Fc receptor inhibitor approved for the treatment of acetylcholine receptor antibody (AChR)-positive generalized myasthenia gravis (MG), has demonstrated efficacy in randomized controlled trials. However, real-world data, particularly from Eastern Europe, remain limited. METHODS: This prospective, multicenter study enrolled AChR-positive generalized MG patients treated with efgartigimod across six Romanian university hospitals between March 2024 and September 2025. Outcomes were assessed using the Myasthenia Gravis Activities of Daily Living (M…

Digital assessment in myasthenia gravis: evidence, validation, and a proposed framework for autoimmune heterogeneity, remote monitoring, and clinical endpoints.

Myasthenia gravis (MG) is an antibody-mediated autoimmune disorder of the neuromuscular junction in which weakness fluctuates across symptom domains, daily activities, and treatment cycles. Established measures such as the Quantitative Myasthenia Gravis score, Myasthenia Gravis Composite, Myasthenia Gravis Activities of Daily Living scale, and MG-specific quality-of-life instruments remain the principal clinical anchors, but intermittent assessments may miss intraday variability, exertional fatigability, and changes across treatment cycles. This structured narrative review examines electronic …

Case Report: Recurrent metastatic thymoma-associated multiple paraneoplastic syndromes: myasthenia gravis, dysgeusia, and acute intestinal pseudo-obstruction.

BACKGROUND: Paraneoplastic syndromes (PNS) are frequently associated with thymoma. The unusual clustering of myasthenia gravis, dysgeusia, and AIPO during thymoma recurrence has been sparsely reported in the literature. CASE PRESENTATION: We report the case of a man who developed pleural metastasis three years after thymoma resection and shortly thereafter experienced dysgeusia, ocular MG (diplopia and ophthalmoplegia), and AIPO. This triad has received limited documentation. Serum testing was positive for acetylcholine receptor antibody (AChR-Ab), anti-MURC antibody, and anti-recoverin antib…

Efgartigimod for Anti-n-Methyl-d-Aspartate Shanxi Provincial People's Hospital, Taiyuan, China Receptor Encephalitis: A Case Report and Literature Review.

INTRODUCTION: Neonatal Fc receptor (FcRn) antagonists can improve autoimmune diseases such as myasthenia gravis by rapidly and selectively reducing serum IgG levels, and they hold potential for broader applications in other autoimmune disorders. CASE PRESENTATION: We report a 32-year-old female admitted with psychiatric and behavioral abnormalities, who tested positive for anti-NMDA receptor antibodies indicative of autoimmune encephalitis. Despite first-line therapy with corticosteroids and intravenous immunoglobulin, her cognitive dysfunction progressively worsened, ultimately rendering her…

Физическая активность, упражнения и реабилитация в Миастении Гравис: систематический обзор и сводный анализ.

Миастения гравис вызывает колебания, оживляемую слабость, создавая неопределенность в отношении физической активности и физических упражнений. В ходе этого систематического обзора были изучены обычная физическая активность и оседлое поведение, препятствия и факторы, препятствующие занятиям спортом, структурированные упражнения, мышечная подготовка дыхательных путей и физическая реабилитация в аутоиммунной миастении. С самого начала был проведен поиск в PubMed, Scopus и Web of Science Core Collection. 30 июль 2026, без даты базы данных или лингвистических фильтров; поиск в обратном направлении

Совпадение в аннотации оригинала
Myasthenia gravis causes fluctuating, fatigable weakness, creating uncertainty about physical activity and exercise. This systematic review examined habitual physical activity and sedentary behaviour, barriers and facilitators to exercise, structured exercise, respiratory muscle training, and physical rehabilitation in autoimmune myasthenia gravis. PubMed, S…

Engineered α9-nAChR-targeting antibodies attenuate nicotine-enhanced triple-negative breast cancer progression and exhibit favorable short-term tolerability in cynomolgus macaques.

Cigarette smoking and nicotine exposure promote breast cancer progression and poor outcomes by aberrantly activating nicotinic acetylcholine … on-human primates, cynomolgus macaque (Macaca fascicularis). did not reveal neuromuscular toxicity, myasthenia gravis-like symptoms, hematologic abnormalities, or overt organ injury within the observation period, supporting a favorable short-term tolerability profile under the tested conditions. In summary, this study identifies α9-nAChR as a key mole …

Regimen-stratified Bayesian model-based meta-analysis of targeted biologics in generalised myasthenia gravis: efficacy comparison, mechanism-level class contrast, and endpoint sensitivity with model-informed trial design.

Nine targeted biologics spanning four mechanisms have reached phase III development for generalised myasthenia gravis, yet no cross-programme comparison accounts for the distinct continuous versus cyclical dosing patterns or integrates both patient-reported (MG-ADL) and clinician-assessed (QMG) scales. We performed a regimen-stratified Bayesian model-based meta-analysis (MBMA) to compare efficacy, evaluate mechanism-level class differences, and inform trial design. Longitudinal MG-ADL and QMG data were extracted from nine placebo-controlled phase III trials. Six hierarchical nonlinear Emax mod…

Real-World Occurrence of Adverse Events Associated With Adjuvant Pembrolizumab Therapy for Renal Cell Carcinoma: A Multicenter Retrospective Study.

BACKGROUND: Pembrolizumab is indicated as adjuvant therapy after nephrectomy in patients with high-risk renal cell carcinoma (RCC). However, … TRAEs included one case each of erythema multiforme, myocarditis, gastrointestinal perforation, and myasthenia gravis. During follow-up, no disease recurrence or death was observed, and the median DFS and OS were not achieved. CONCLUSIONS: The safety profile of pembrolizumab as an adjuvant therapy was found to be acceptable in Japanese patients with …

Managing myasthenic crisis after video-assisted thoracoscopic thymectomy with therapeutic plasma exchange.

Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disorder marked by fluctuating skeletal muscle weakness, with thymectomy being a key therapeutic option particularly in thymoma-associated cases. We report a 24-year-old female patient with early-onset MG who underwent video-assisted thoracoscopic thymectomy (VATS). Despite adequate preoperative stabilization with therapeutic plasma exchange (TPE), she developed a postoperative myasthenic crisis requiring intensive care and ventilatory support. Early recognition of clinical deterioration and prompt initiation of additional TPE sessio…

Minimally Invasive Approaches for Thymectomy: A Narrative Review and Comparison of Surgical Approaches.

BACKGROUND: There are various approaches to minimally invasive thymectomy. This review discusses the various techniques and provides a compa … to work. A left sided approach may provide some benefit over right sided approaches, especially for Myasthenia Gravis. Subxiphoid approaches may provide superior visualization to either lateral approach. A single port robotic subxiphoid approach holds significant promise, but it remains early in its adoption. CONCLUSIONS: The use of minimally invasiv …