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لماذا يجب ان نقوم باختبارات الوظيفة الدرقية عند مرضى الوهن العضلي الوخيم myasthenia gravis ؟


لماذا يجب ان نقوم باختبارات الوظيفة الدرقية عند مرضى الوهن العضلي الوخيم myasthenia gravis ؟

المعلومة

لماذا يجب ان نقوم باختبارات الوظيفة الدرقية عند مرضى الوهن العضلي الوخيم myasthenia gravis ؟

المرجع

medstudy
by


لان اختبارات الوظيفة الدرقية تكون غير طبيعية في 30% عند هؤلاء المرضى .

qusei


شكرا قصي

طبعا الMG\ مرض مناعي وممكن يرافق امراض مناعية أخرى مثل
SLE,RA , MS , DM1
اضافة لالتهاب الغدة الدرقية

فلازم ننتبه

moonberg's picture
moonberg
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Quote:
طبعا الMG\ مرض مناعي وممكن يرافق امراض مناعية أخرى مثل

حاحكي عن المرض بس شوي شوي Eye-wink

qusei

Quote:
حاحكي عن المرض بس شوي شوي

روح وانا شايفلك سيد قصي

مشكور على هالمعلومات الحلوة

mbs2380's picture
mbs2380
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الله يخليلنا ياك عمي قصي Laughing out loud Laughing out loud Laughing out loud Laughing out loud

Vince Carter


بالانتظارEye-wink

moonberg's picture
moonberg
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شكراً...

Fouad's picture
Fouad
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Quote:
لان اختبارات الوظيفة الدرقية تكون غير طبيعية في 30% عند هؤلاء المرضى

Moreover, hyperthyrodisim aggravates MG, so managing hyperthyroid (if was) will help myasthenia

Ghufran's picture
Ghufran
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ما السبب في أن فرط نشاط الدرق يسيء من الوهن العضلي الوخيم ؟

Al Durra's picture
Al Durra
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Maybe because the prescence of fine trmor will put more load on the diseased NMJ,so fatigue ensues more rapidly

Ghufran's picture
Ghufran
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شكرا لك ...يبدو أن السبب يكمن في الآلية المناعية المتشابهة
لمزيد من التوضيح هذا ما وجدته في UPT

Myasthenia gravis — It is generally recognized that there is an association between myasthenia gravis and hyperthyroidism, particularly Graves' disease. The reported prevalence of hyperthyroidism in series of patients with myasthenia gravis (MG) ranges between 2 to 17 percent, compared with a 1 in 10,000 prevalence in the general population [54-56]. Less than one percent of patients with MG have hyperthyroidism.

The relationship between the two disorders is likely a shared autoimmune pathogenesis. Some, but not all, case series and case control studies have reported higher prevalence of antithyroid antibodies among patients with MG [55-57].

A closer association between the two disorders is also suggested by the following observations: In 44 of 51 of patients with MG and hyperthyroidism in one series, thyrotoxicosis occurred simultaneously with or prior to the development of MG [54]. More than half of the patients demonstrated parallel disease activity with worsening of both diseases over a similar period of time. The clinical manifestations of MG patients may be influenced by comorbid autoimmune thyroid disease. In one study, MG associated with autoimmune thyroid disease was found to have a higher proportion of ocular MG compared with patients with MG without thyroid disease (41 versus 21 percent), as well as a lower frequency of thymic disease (27 versus 60 percent) and acetylcholine receptor antibodies (36 versus 57 percent) [58]. The association between ocular MG and Graves' disease may reflect immunological cross-reactivity against common autoimmune targets in the eye muscle [59]. However, in another case series, generalized MG predominated, in two-thirds of 56 patients with thyrotoxicosis and MG [54]. There may also be common genetic susceptibility in the two disorders. In one case series, all five patients with both MG and Graves' disease had in common the HLA antigen type, HLA-DQ3 [60].

Ocular MG and Graves' ophthalmopathy have overlapping symptoms but can generally be distinguished. Ptosis and orbicularis oculi weakness suggest ocular MG, while proptosis, lid retraction, lid lag, periorbital edema, and restricted eye movement with forced ductions suggest Graves' ophthalmopathy. (See "Ocular myasthenia gravis", section on Differential diagnosis, and see "Pathogenesis and clinical features of Graves' ophthalmopathy (orbitopathy)", section on Differential diagnosis).

The treatment and prognosis of MG is similar in patients with and without hyperthyroidism and consists of acetylcholinesterase inhibitors, immunosuppressive therapy, and thymectomy [55,61]. (See "Treatment of myasthenia gravis").

Treatment of hyperthyroidism alone does not usually affect MG, although both improvement and worsening of MG symptoms with thyroid lowering have been described [62,63]. When the thyroid disorder is due to autoimmunity, immunosuppressive medications may lead to remission of both disorders [54]. Thymectomy appears to have no influence on hyperthyroidism.

Al Durra's picture
Al Durra
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شكراً لكم Eye-wink

DAM's picture
DAM

Quote:
Ptosis and orbicularis oculi weakness

usually pts come saying i woke up today normal , then after two hours my eye's lids started to close and u will notice that their eye brows are elevated in trial to help elevate their ptotic eye lids

and btw if a MG pt is insomnic never give benzos or barbiturates cuz both are muscle relaxant - anticonvulsant

--------

another thing :

also check in diabetic pts for thyroid hormone levels ,

a GP doc told me that they estimated in a clinic audit that every 6 pts with DMII, 5 of them have hypothyroidism !

Quote:
The relationship between the two disorders is likely a shared autoimmune pathogenesis.

exactly ,
so stress on that : this is co-existance relation not a consequential relation

y3ne they might co-exist , but one doesnt cause the another

امرأة لا تتكرر's picture
امرأة لا تتكرر
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and

up

mbs2380's picture
mbs2380
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الله يرحم إيام حكيم الطبي

moonberg's picture
moonberg
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هيك نوع من الأسئلة والنقاشات هو ما يعلق بذهني بسهولة عادة

شكراً كتير عالمعلومات المفيدة ^^

prettyflower's picture
prettyflower
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Quote:
الله يرحم إيام حكيم الطبي

اي والله يا صاحبي......
Eye-wink

هلأ بعد ما قطعنا الامل عمنحاول نركز اكتر على حكيم التحشيشي ....ان شاء الله بدنا نحاول نفتح "حكيم التحشيشي" قريباً ......
لانو لقينا السوق تبعو ضارب اكتر ,... Laughing out loud

Quote:
هيك نوع من الأسئلة والنقاشات هو ما يعلق بذهني بسهولة عادة

شكراً كتير عالمعلومات المفيدة ^^

100 %

mbs2380's picture
mbs2380
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شكرا

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اللؤلؤة
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