Refractory myasthenia gravis. Myasthenia gravis (MG) is an autoimmune neuromuscular junction disor...

17 февр. 2018 г. ... Rituximab in Treatment-Refractory Myasthenia

The Myasthenia Gravis Foundation of America defines refractory MG as "Post-intervention status is unchanged or worse after corticosteroids and at least two other immunosuppressive agents, used in ...Nov 9, 2021 · All the above-mentioned favorable outcomes of rituximab in refractory myasthenia gravis patients have widened the options for treatment of refractory myasthenia gravis; they have also demonstrated that RTX could improve patients' quality of life by decreasing dose-related adverse effects and sustaining remission [10,12-17]. Even though RMG ... Jan 23, 2023 · What is myasthenia gravis? Myasthenia gravis is a chronic autoimmune, neuromuscular disease that causes weakness in the skeletal muscles (the muscles that connect to your bones and contract to allow body movement in the arms and legs, and allow for breathing). The hallmark of myasthenia gravis is muscle weakness that worsens after periods of ... Background: This retrospective cohort study was conducted to evaluate the efficacy and tolerance of rituximab (RTX) for the management of myasthenia gravis (MG). Methods: This retrospective cross-sectional study was conducted on 61 patients with refractory and non-refractory MG who received RTX. The Myasthenia Gravis …Grayson Beecher. 29742795. 10.1002/mus.26156. Rituximab appears to be beneficial in treatment-refractory myasthenia gravis (MG); however, prospective, long-term durability data are lacking. In this prospective, open-label study of rituximab in refractory MG, 22 patients (10 nicotinic acetylcholine receptor, 9 muscle-specific tyrosine kinase, 3 ...SYSTEMATIC REVIEW article Front. Neurol., 13 October 2021 Sec. Neuromuscular Disorders and Peripheral Neuropathies Volume 12 - 2021 | https://doi.org/10.3389/fneur.2021.736190 Effectiveness and Safety of Rituximab for Refractory Myasthenia Gravis: A Systematic Review and Single-Arm Meta-AnalysisIntroduction: Myasthenia gravis, an autoimmune disorder of neuromuscular transmission, is treated by an array of immunomodulating therapies. A variable response is observed with certain patients being medically refractory. Methods: We report the results of 14 refractory generalized myasthenia gravis patients (6 AChR+; 8 MuSK+) treated with rituximab. ...Introduction Myasthenia gravis (MG) is a rare, debilitating, chronic disorder caused by the production of pathogenic immunoglobulin G autoantibodies against the neuromuscular junction. A lack of real-world studies in rare diseases reflects a relatively limited understanding of the significant unmet needs and burden of disease for patients. We aimed to provide comprehensive real-world insights ...Aug 26, 2021 · Zytux in Refractory Myasthenia Gravis: A Multicenter, Open-Labeled, Clinical Trial Study of Effectiveness and Safety of a Rituximab Biosimilar Farzad Fatehi , 1 Kamyar Moradi , 1 Ali Asghar Okhovat , 1 , 2 Ghazaleh Shojatalab , 1 Behnaz Sedighi , 3 Reza Boostani , 4 Payam Sarraf , 5 , 6 Bahram Haghi Ashtiani , 7 Majid Ghasemi , 8 Soussan ... Myasthenia gravis (MG) exemplifies autoimmune disease. Most patients require immunomodulating treatment, including steroids, chemotherapy, or intravenous immunoglobulin (Ig), in addition to anticholinesterase treatment. Drachman et al 1 published the beneficial effects of high dose cyclophosphamide in three patients with severe refractory myasthenia.Rituximab improves clinical characteristics in patients with refractory myasthenia gravis (MG). (A) Scatter plot of the effect of rituximab on MMT score in refractory MG patients treated with a single cycle of rituximab. (B) Plots demonstrating the time to peak response in these refractory patients. (C) Column plots showing the steroid …Myasthenia gravis (MG) is an autoimmune neuromuscular disorder characterized by fatigable muscle weakness. MG is specifically thought to be an antibody-mediated disease. MG can be …Oct 11, 2021 · Myasthenia gravis (MG) is a rare classic autoimmune disease where immunosuppressant therapies have been successful to reduce MG attributable mortality fairly well. However, patients with refractory MG (rMG) among the actively treated MG (aMG) are nonresponsive ... The findings suggest that, although most patients with refractory gMG will achieve clinical response by Week 12 of eculizumab treatment, first responses can be observed with longer-term treatment. ... Generalized myasthenia gravis (gMG) is an autoimmune disease that causes disabling weakness via damage to the neuromuscular junction. In most ...33172684. 10.1016/j.nrl.2020.08.016. Advances in the treatment of myasthenia gravis (MG) have improved quality of life and prognosis for the majority of patients. However, 10%-20% of …Methods: This study was a randomized, double-blind, placebo-controlled, crossover trial involving 14 patients with severe, refractory generalized MG (gMG). Results: Six of 7 patients treated with eculizumab for 16 weeks (86%) achieved the primary endpoint of a 3-point reduction in the quantitative myasthenia gravis (QMG) score. Examining both ...When myasthenia gravis is deemed refractory: clinical signposts and treatment strategies. Ther Adv Neurol Disord . 2018;11:1756285617749134. Blum S, Lee D, Gillis D, McEniery DF, Reddel S, McCombe P. Clinical features and impact of myasthenia gravis disease in Australian patients.For steroid-refractory myocarditis supplementary immune suppressive agents are recommended. Yet, data still relies on case reports and case series, due to lack of prospective studies. ... (MMF). A 57-year-old male with metastatic renal cell carcinoma was diagnosed with immune-related myocarditis and myasthenia gravis-like myositis …Symptoms The following symptoms are commonly associated with myasthenia gravis: Weakness of the eye muscles (ocular myasthenia) Drooping of one or both eyelids (ptosis) Blurred or double vision (diplopia) Changes in facial expressions Difficulty swallowing Shortness of breath Impaired speech (dysarthria)Side effects, which usually are mild, can include chills, dizziness, headaches and fluid retention. Monoclonal antibody. Rituximab (Rituxan) and eculizumab (Soliris) are medicines given by vein for myasthenia gravis. These medicines are usually used when other treatments don't work. They can have serious side effects.Mar 1, 2019 · Vissing J, O’Brien F, Wang JJ, et al. Correlation between myasthenia gravis-activities of daily living (MG-ADL) and quantitative myasthenia gravis (QMG) assessments of anti-acetylcholine receptor antibody-positive refractory generalized myasthenia gravis in the phase 3 REGAIN study. Introduction Myasthenia gravis (MG) is an autoimmune neuromuscular disorder characterized by fatigable muscle weakness. MG is specifically thought to be an antibody-mediated disease. In approximately 85 percent of patients, antibodies are detected against the nicotinic acetylcholine receptor (nAChR) at the neuromuscular junction [ 1 - 3 ].Objective To assess rituximab in refractory and new-onset generalized myasthenia gravis and rituximab vs conventional immunotherapy in new-onset disease. Design, Setting, and Participants A retrospective cohort study with prospectively collected data was conducted on a county-based community sample at Karolinska University Hospital, Stockholm ...12 мая 2022 г. ... Post-thymectomy myasthenia gravis (PTMG) is defined as thymoma patients without signs of myasthenia gravis (MG) pre-operation, ...An 8 year old girl with ocular myasthenia gravis was treated with high dose intravenous immunoglobulin and high dose intravenous methylprednisolone. Ocular ...Objective: We describe a case of refractory myasthenia gravis with bulbar involvement and the nutritional treatment solutions proposed to treat the associated dysphagia and malnutrition. Methods: A 39-y-old woman with refractory myasthenia gravis was referred to our clinical nutrition unit for deteriorating dysphagia and progressive malnutrition.Background. Complement is likely to have a role in refractory generalised myasthenia gravis, but no approved therapies specifically target this system. Results from a phase 2 study suggested that eculizumab, a terminal complement inhibitor, produced clinically meaningful improvements in patients with anti-acetylcholine receptor antibody …Background and purpose: Defining refractory myasthenia gravis is important, as this can drive clinical decision making, for example, by escalating treatments in refractory individuals. There are several definitions of refractory myasthenia, and their performances have not been compared. Having valid and reliable criteria can help select patients in …Abstract. The humanized monoclonal antibody eculizumab (Soliris ®) is a complement inhibitor indicated for use in anti-acetylcholine receptor (AChR) antibody-positive adults with generalized myasthenia gravis (gMG) in the USA, refractory gMG in the EU, or gMG with symptoms that are difficult to control with high-dose IVIg therapy or PLEX in Japan.Vissing J, O’Brien F, Wang JJ, et al. Correlation between myasthenia gravis-activities of daily living (MG-ADL) and quantitative myasthenia gravis (QMG) assessments of anti-acetylcholine receptor antibody-positive refractory generalized myasthenia gravis in the phase 3 REGAIN study.Introduction: Rituximab appears to be beneficial in treatment-refractory myasthenia gravis (MG); however, prospective, long-term durability data are lacking. Methods: In this prospective, open-label study of rituximab in refractory MG, 22 patients (10 nicotinic acetylcholine receptor, 9 muscle-specific tyrosine kinase, 3 seronegative) received …Abstract. Muscle-specific tyrosine kinase (MuSK) myasthenia gravis (MG) is a rare, frequently more severe, subtype of MG with different pathogenesis, and peculiar clinical features. The prevalence varies among countries and ethnic groups, affecting 5–8% of all MG patients. MuSK-MG usually has an acute onset affecting mainly the facial-bulbar ...An early onset of myasthenia gravis was associated with a higher risk for a refractory course. Conclusion. A small subgroup of patients with generalized myasthenia …Introduction. The main reason for the development of new therapeutic strategies in MG is the need for more specific and more effective drugs in particular in so-called refractory or difficult-to-treat/treatment resistant autoimmune myasthenia gravis. 1,2 The inability to achieve sufficient clinical improvement with minimal symptom expression …Introduction: Rituximab appears to be beneficial in treatment-refractory myasthenia gravis (MG); however, prospective, long-term durability data are lacking. Methods: In this prospective, open-label study of rituximab in refractory MG, 22 patients (10 nicotinic acetylcholine receptor, 9 muscle-specific tyrosine kinase, 3 seronegative) received …The Myasthenia Gravis Foundation of America defines refractory MG as “Post-intervention status is unchanged or worse after corticosteroids and at least two other immunosuppressive agents, used in adequate doses for an adequate duration, with persistent symptoms or side effects that limit functioning, as defined by patient and physician ...Einleitung: Myasthenia gravis (MG) ist eine neuromuskuläre Autoimmunerkrankung, die durch eine belastungsabhängige Muskelschwäche …Introduction: Myasthenia gravis, an autoimmune disorder of neuromuscular transmission, is treated by an array of immunomodulating therapies. A variable response is observed with certain patients being medically refractory. Methods: We report the results of 14 refractory generalized myasthenia gravis patients (6 AChR+; 8 MuSK+) treated with ...Myasthenia gravis (MG) is a neurological B-cell mediated autoimmune disorder affecting the neuromuscular junction. MG therapeutics have always relied on nonselective immunosuppression with oral steroids and non-steroidal immunosuppressants, mainly with good clinical response. However, clinical stabilization is often reached at the cost of many ...Introduction: This study assessed the clinical burden of refractory myasthenia gravis (MG), relative to nonrefractory MG. Methods: Rates of myasthenic crises, exacerbations, inpatient hospitalizations, and emergency room (ER) visits over a 1-year period were measured for 403 refractory, 3,811 nonrefractory, and 403 non-MG control patients from two administrative health plan databases.Treatment of Patients With Severe Weakness and Refractory Myasthenia Gravis. When treating patients with new-onset MG with severe weakness, it is preferable to start with IVIg, efgartigimod, or plasma exchange, followed by maintenance immunosuppressants.Jan 19, 2021 · The Article Processing Charge was funded by the Myasthenia Gravis Foundation of America. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to None. Patients can learn over time to adjust dosage; with current dosing, cholinergic crisis is rare. Prednisone. Rapid induction regimen: 60–100 mg/d for 2–4 wk; slow titration regimen: 10 mg/d, increase by 10 mg every 5–7 d up to 60–100 mg. 60–100 mg/d, followed by a slow alternate day taper. 2–4 wk.Myasthenia Gravis (QMG) score,25 the revised 15-item Myasthenia Gravis Quality of Life (MG-QOL15r) question-naire,26 and the Neurological Quality of Life (Neuro-QoL) Fatigue subscale.27 A copy of each measure is provided in the Supplementary Appendix (pages 24–28). The MG-ADL is an 8-item survey of patient-reported MG symptomJun 22, 2023 · Side effects, which usually are mild, can include chills, dizziness, headaches and fluid retention. Monoclonal antibody. Rituximab (Rituxan) and eculizumab (Soliris) are medicines given by vein for myasthenia gravis. These medicines are usually used when other treatments don't work. They can have serious side effects. Myasthenia gravis (MG) is a chronic rare autoimmune disease characterized by severe muscle weakness and caused by the inhibition of neuromuscular transmission due to the binding of autoantibodies at the neuromuscular junction and subsequent complement-mediated destruction of the end-plate region. The prevalence of MG has been estimated as ...12 авг. 2019 г. ... Operational criteria for "refractory" generalized myasthenia gravis include the failure of multiple therapies, the need for regular use of IVIG ...Myasthenia gravis (MG) is a relatively rare autoimmune disorder in which antibodies form against acetylcholine nicotinic postsynaptic receptors at the neuromuscular junction of skeletal muscles (see the image below). ... Safety and efficacy of eculizumab in anti-acetylcholine receptor antibody-positive refractory generalised myasthenia gravis ...Oct 13, 2021 · Background and Objective: Myasthenia gravis (MG) is an autoimmune neuromuscular disease. Nearly 10–30% of patients with MG are refractory to conventional therapy. Rituximab (RTX), a monoclonal antibody targeting CD20, is increasingly used in autoimmune disorders. We performed a systematic review and meta-analysis to evaluate the effectiveness and safety of RTX for refractory MG.Methods ... Abstract. Myasthenia gravis (MG), a prototype autoimmune neurological disease, had its therapy centred on corticosteroids, non-steroidal broad-spectrum immunotherapy and cholinesterase inhibitors for several decades. Treatment-refractory MG and long-term toxicities of the medications have been major concerns with the conventional therapies.Jun 22, 2023 · Side effects, which usually are mild, can include chills, dizziness, headaches and fluid retention. Monoclonal antibody. Rituximab (Rituxan) and eculizumab (Soliris) are medicines given by vein for myasthenia gravis. These medicines are usually used when other treatments don't work. They can have serious side effects. Introduction: This study assessed the clinical burden of refractory myasthenia gravis (MG), relative to nonrefractory MG. Methods: Rates of myasthenic crises, exacerbations, inpatient hospitalizations, and emergency room (ER) visits over a 1-year period were measured for 403 refractory, 3,811 nonrefractory, and 403 non-MG control patients from two administrative health plan databases.Key Points. Question Does the response to rituximab differ between patients with new-onset vs refractory generalized myasthenia gravis, and how does rituximab compare with conventional immunotherapy in these patients?. Findings In this cohort study of 72 patients exposed to rituximab early or later in the myasthenia gravis disease course as well as …Methods: A 39-y-old woman with refractory myasthenia gravis was referred to our clinical nutrition unit for deteriorating dysphagia and progressive malnutrition. Results: The first-line nutritional approach consisted of dietary counseling and thickened meals. Unfortunately, no adequate oral intake was achieved and an enteral nutrition treatment ...May 3, 2022 · RTX also has beneficial effects in refractory MG. 25 In a prospective study by Fatehi et al, 34 patients with refractory MG had significant decreases in Myasthenia Gravis Composite (MGC) and MG-ADL scores after treatment with Zytux, an RTX biosimilar. 26 In a retrospective study with a 10-year follow-up, sustained clinical remission was ... Background. Complement is likely to have a role in refractory generalised myasthenia gravis, but no approved therapies specifically target this system. Results from a phase 2 study suggested that eculizumab, a terminal complement inhibitor, produced clinically meaningful improvements in patients with anti-acetylcholine receptor antibody …Brauner, S. et al. Comparison between rituximab treatment for new-onset generalized myasthenia gravis and refractory generalized myasthenia gravis. JAMA Neurol. 77, 974–981 (2020).Introduction: Myasthenia gravis, an autoimmune disorder of neuromuscular transmission, is treated by an array of immunomodulating therapies. A variable response is observed with certain patients being medically refractory. Methods: We report the results of 14 refractory generalized myasthenia gravis patients (6 AChR+; 8 MuSK+) treated with rituximab. ...Introduction: Refractory myasthenia gravis (MG) is defined as a failure to respond adequately to conventional therapies, the inability to reduce immunosuppressive therapy without clinical relapse or the need for ongoing rescue therapy, severe adverse effects from immunosuppressive therapy (treatment intolerant) or frequent myasthenic crisis even on therapy.RTX also has beneficial effects in refractory MG. 25 In a prospective study by Fatehi et al, 34 patients with refractory MG had significant decreases in Myasthenia Gravis Composite (MGC) and MG-ADL scores after treatment with Zytux, an RTX biosimilar. 26 In a retrospective study with a 10-year follow-up, sustained clinical remission was ...SYSTEMATIC REVIEW article Front. Neurol., 13 October 2021 Sec. Neuromuscular Disorders and Peripheral Neuropathies Volume 12 - 2021 | https://doi.org/10.3389/fneur.2021.736190 Effectiveness and Safety of Rituximab for Refractory Myasthenia Gravis: A Systematic Review and Single-Arm Meta-AnalysisMyasthenia gravis (MG) is a rare autoimmune disease characterised by antibody-mediated interference with neuromuscular transmission at the neuromuscular junction [].MG is classed as a rare disease, and its prevalence is estimated to be about 1–2 per 10,000 people [].However, reported incidence rates are increasing, partly due to …The traditional treatment of inflammatory myopathies (IM) and generalized myasthenia gravis (MG) is immunosuppressive therapy, usually beginning with ...Rituximab improves clinical characteristics in patients with refractory myasthenia gravis (MG). (A) Scatter plot of the effect of rituximab on MMT score in refractory MG patients treated with a single cycle of rituximab. (B) Plots demonstrating the time to peak response in these refractory patients. (C) Column plots showing the steroid sparing ...Jan 1, 2021 · Patients Who Achieved Myasthenia Gravis Foundation of America Post-intervention Status of Improved or Minimal Manifestations at REGAIN (Safety and Efficacy of Eculizumab in Anti-acetylcholine Receptor-Positive Refractory Generalized Myasthenia Gravis) Weeks 4, 12, and 26, and Open-Label Study Weeks 26, 52, 78, 104, and 130 Objective To update the 2016 formal consensus-based guidance for the management of myasthenia gravis (MG) based on the latest evidence in the literature. Methods In October 2013, the Myasthenia Gravis Foundation of America appointed a Task Force to develop treatment guidance for MG, and a panel of 15 international experts was convened. The RAND/UCLA appropriateness method was used to develop ...Background: Life-threatening myasthenic crisis (MC) occurs in 10–20% of the patients with myasthenia gravis (MG). It is important to identify the predictors of progression to MC and prognosis in the patients with MG with acute exacerbations.Objective: This study aimed to explore the predictors of progression to MC in the patients with MG with acute …We report on a patient with refractory Myasthenia gravis with acetylcholine receptor antibodies with two prior myasthenic crises suffering from COVID-19 with rapid evolving weakness and respiratory failure. Respiratory failure developed and prolonged mechanical ventilation was necessary. After plasmapheresis, residual, severe …Objective: To describe the clinical characteristics and outcomes in patients with refractory myasthenia gravis (MG) and to determine the effectiveness and side effects of the drugs used for their treatment. Methods: This observational retrospective cross-sectional multicenter study was based on data from the Spanish MG Registry (NMD-ES).Introduction Myasthenia gravis (MG) is a rare, debilitating, chronic disorder caused by the production of pathogenic immunoglobulin G autoantibodies against the neuromuscular junction. A lack of real-world studies in rare diseases reflects a relatively limited understanding of the significant unmet needs and burden of disease for patients. We aimed to provide comprehensive real-world insights ...Jul 20, 2022 · Introduction Myasthenia gravis (MG) is a rare, debilitating, chronic disorder caused by the production of pathogenic immunoglobulin G autoantibodies against the neuromuscular junction. A lack of real-world studies in rare diseases reflects a relatively limited understanding of the significant unmet needs and burden of disease for patients. We aimed to provide comprehensive real-world insights ... Conclusion. Our investigation revealed the effect of a low dose of rituximab (RTX) in improving the clinical symptoms and reducing steroid dosage in refractory generalized myasthenia gravis (MG). A low dose of RTX infusion was sufficient to reduce CD19 + B cells (< 1%) and was effective to maintain CD19 + B cell < 1% 6 months after infusion.Jun 1, 2014 · Myasthenia gravis (MG) is the most common disorder of neuromuscular transmission and is a prototypical autoimmune disorder. Most patients with MG are successfully treated with acetylcholinesterase ... Myasthenia gravis is a neuromuscular autoimmune disease characterized by fatigable weakness of skeletal muscles that results from an antibody-mediated immunological attack directed at acetylcholine postsynaptic receptors. Autologous hematopoietic stem cell transplantation is considered as a treatment option in refractory cases of myasthenia gravis.We describe a case of refractory myasthenia gravis with bulbar involvement and the nutritional treatment solutions proposed to treat the associated dysphagia and malnutrition. Methods. A 39-y-old woman with refractory myasthenia gravis was referred to our clinical nutrition unit for deteriorating dysphagia and progressive malnutrition.12 мая 2022 г. ... Post-thymectomy myasthenia gravis (PTMG) is defined as thymoma patients without signs of myasthenia gravis (MG) pre-operation, ...7 мар. 2019 г. ... Aims: To examine healthcare resource utilization associated with refractory myasthenia gravis (MG) in England.Materials and methods: This ...The most frequently used immunosuppressive therapies for drug-refractory and non-drug-refractory MG patients are shown in Figure S1A. Drug-refractory patients needed intravenous immunoglobulin (86.9% vs. 23.7%, p < 0.0001) and plasma exchange (19% vs. 4.4%, p < 0.0001) more frequently than non-drug-refractory patients at some point of the ...Abstract. Introduction Rituximab is a monoclonal chimeric antibody against CD20+ B cells. We aimed to assess the long-term efficacy and safety of CD20+ B cell-guided treatment with low-dose rituximab in refractory myasthenia gravis patients. Methods Patients with refractory myasthenia gravis treated with rituximab for more than 2 years were ...Jun 13, 2013 · Background: A subset of myasthenia gravis (MG) patients is refractory to standard therapies. Identifying the characteristics of this population is essential as newer treatment strategies emerge that may be more effective in this group.Objective: The aim ... Treatment of Patients With Severe Weakness and Refractory Myasthenia Gravis. When treating patients with new-onset MG with severe weakness, it is preferable to start with IVIg, efgartigimod, or plasma exchange, followed by maintenance immunosuppressants. Methods: This study was a randomized, double-blind, placebo-controlled, crossover trial involving 14 patients with severe, refractory generalized MG (gMG). Results: Six of 7 patients treated with eculizumab for 16 weeks (86%) achieved the primary endpoint of a 3-point reduction in the quantitative myasthenia gravis (QMG) score. Examining both ...Brauner, S. et al. Comparison between rituximab treatment for new-onset generalized myasthenia gravis and refractory generalized myasthenia gravis. JAMA Neurol. 77, 974–981 (2020).Jan 19, 2021 · Objective To update the 2016 formal consensus-based guidance for the management of myasthenia gravis (MG) based on the latest evidence in the literature. Methods In October 2013, the Myasthenia Gravis Foundation of America appointed a Task Force to develop treatment guidance for MG, and a panel of 15 international experts was convened. The RAND/UCLA appropriateness method was used to develop ... . SYSTEMATIC REVIEW article. Front. Neurol., 13 October 2021. Sec. NIntroduction: Approximately 10–20% of patients WITH myast Go to: Key Messages Low-quality evidence suggests that treatment with rituximab may be associated with improvements in clinical status, use of concurrent immunomodulatory therapies, quality of life, and various laboratory parameters in patients with myasthenia gravis, compared to before treatment.Myasthenia gravis (MG) is an immune-mediated disorder with a variable response to treatment. In this study, patients with refractory MG who were treated with rituximab were identified. A review of patients referred to the Yale Neuromuscular Clinic was performed. Patients with refractory MG who were … Introduction: Advances in the treatment of myasthenia Jan 19, 2021 · The Article Processing Charge was funded by the Myasthenia Gravis Foundation of America. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to INTRODUCTION Myasthenia gravis (MG) is an autoimmune neuromuscular disorder characterized by fluctuating motor weakness involving ocular, bulbar, limb, and/or respiratory muscles. Refractory myasthenia gravis – clinical pr...

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