22 KB67 KB21 KB192920262001Hojs-Fabjan, TanjaŽitnik, Lidijaštevilka:12letnik:70str. 723-725ISSN:1318-0347COBISSID:827455URN:URN:NBN:SI:doc-6DGYVLFTslSlovensko zdravniško društvoZdravniški vestnikavtoimunske bolezniImmunization, passiveImunizacija, pasivnaimunologijaMiastenija gravisMyasthenia gravistherapyThyroid diseasesTireopatijezdravljenjeMiastenija gravis in avtoimuna tireopatija| Myasthenia gravis and autoimmune thyroid disease|Background. Myasthenia gravis is an autoimmune disease mediated by autoantibodies against the nicotinic acetylholin receptors at the neuromuscular junction. Patients with myasthenia gravis often have circulating antibodies against a variety of tissue constituents. Several studies have shown an increased occurrence of other autoimmune diseases. Patients and methods. The authors presented a patient with generalized myasthenia gravis, which considerably weakened the oropharyngeal muscle and caused ocular palsies. At the same timethe patient's autoimmune thyroid disease with hypotireosis was discovered. At first the patient reacted well tothe therapy with pyridostigmin bromid and levotiroxin but after six months her clinical status worsened, what was mainly seen as oropharingeal muscle weakness, ocular palsies, ptosis and weakness of proximal arm muscles. The authors decided for the additional treatment with intravenous immnunoglobulinsand immunosupressive therapy. Conclusions. The authors describes a case of a patient with myasthenia gravis and associated autoimmune thyroid disease with hypotireosis. It is generally known that autoimmune diseases can be associated with myasthenia gravis, which could trigger or worsen the disease. That is why we always have to think of a possibility of other associated autoimmune diseases and broaden the diagnostic researchIzhodišča. Miastenija gravis je avtoimunska bolezen, ki jo povzročijo protitelesa proti nikotinskim acetilholinskim receptorjem živčnomišičnega stika. Bolniki z miastenijo gravis imajo pogosto tudi cirkulirajoča protitelesa proti različnim tkivnim sestavinam, raziskave so pokazale povečano soprisotnost drugih avtoimunskih bolezni. Te lahko miastenijo sprožijo ali poslabšajo. Bolniki in metode. Avtorici opisujeta primer bolnice s sistemsko obliko miastenije gravis s pretežno prizadetostjo bulbarnega mišičja, mišic zrkel in dvigovalk vek. Sočasno sta ugotovili, da gre pri bolnici za avtoimunsko tireopatijo s hipotireozo. Bolnica se je najprej dobro odzvala na terapijo s piridostigmin bromidom in levotiroksinom, po šestih mesecih pa je prišlo do poslabšanja klinične slike, predvsem v smislu težjeprizadetosti bulbarnega mišičja, mišičnih zrkel in dvigovalke desne veke ter oslabljene moči zgornjih udov. Odločili so se za dodatno imunosupresivno zdravljenje in zdravljenje z imunoglobulini. Zaključki. V prispevku sta avtorici prikazali primer bolnice z miastenijo gravis s pridruženo avtoimunsko tireopatijo s hipotireozo. Znano je, da so avtoimunske bolezni lahko pridružene miasteniji gravis, zato je ob postavitvi diagnoze miastenije gravis vedno treba pomisliti še na druge, pridružene avtoimunske bolezni in razširiti diagnostične preiskaveTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo