• Korean Journal of Veterinary Research
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• v.54 no.1
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• pp.59-62
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• 2014

A 12-year-old, castrated male Yorkshire terrier dog presented with frequent regurgitations that had begun 45 days earlier and become more progressive. Radiographs revealed an air-trap region behind the cranial esophageal sphincter muscle in the esophagus and esophagographies with barium contrast showed mild esophageal dilation with decreased motility. Esophageal motility increased within 5 min of neostigmine methylsulfate administration and acetylcholine receptor antibodies titer increased to beyond the normal range. Based on these findings, acquired myasthenia gravis with focal form was diagnosed, making this the first such case diagnosed by an acetylcholine receptor antibody test in Korea.

• Korean Journal of Veterinary Research
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• v.56 no.2
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• pp.121-123
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• 2016

A 7-year-old castrated male domestic short-hair cat presented with anorexia, constipation, depression, and voice alteration. Physical and neurological examinations revealed hyperthermia ($40.5^{\circ}C$), ventroflexion of the neck, reduced responses to external stimuli, generalized muscle weakness, and exercise intolerance. Thoracic radiographs revealed the presence of a cranial mediastinal mass. The history, clinical signs, and other examination results were compatible with acquired myasthenia gravis (MG). Acetylcholine receptor (AChR) antibody titers were determined to confirm MG and the serum AChR antibody concentration was 1.24 nmol/L (reference interval, < 0.3 nmol/L). This is the first diagnosis of acquired MG in a cat in Korea.

• Clinical and Experimental Reproductive Medicine
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• v.31 no.3
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• pp.149-154
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• 2004

Objective: To assess the association with autoimmune endocrine diseases and detection rate of autoimmune antibodies and its clinical significance in patients with premature ovarian failure. Methods: Twenty eight patients with primary or secondary amenorrhea manifesting hormonal and clinical features of premature ovarian failure (primary POF: 7, secondary POF: 21) were investigated. We tested them TFT, 75 g OGTT, ACTH and S-cortisol for thyroiditis, IDDM, Addison's disease, and antithyoglobulin antibody, antimicrosomal antibody, antinuclear antibody, rheumatic factor, anti-smooth muscle antibody, anti-acetylcholine receptor antibody for non-organ specific autoimmune disorders. Results: Only one patient was diagnosed as IDDM and no patients had abnormal TFT or adrenal function test. More than one kind of autoantibody was detected in 11 patients of all (39.2%): 5 patients (71.4%) of primary POF group and 6 patients (21.4%) of secondary POF group. Eleven patients (39.3%) had antithyroglobulin antibody, 4 (14.3%) had antimicrosomal antibody, 2 (7.1%) had antinuclear antibody, 2 (7.1%) had rheumatic factor, 1 (3.6%) had anti-smooth muscle antibody, 1 (3.6%) had anti-acetylcholine receptor antibody. Conclusions: Premature ovarian failure may occur as a component of an autoimmune polyglandular syndrome, so patients should be measured with free thyroxine, thyroid-stimulating hormone, fasting glucose and electrolytes. Measurement of thyroid autoantibodies in POF patients may be important in identifying patients at risk of developing overt hypothyoidism, but other autoantibodies may not be suitable for screening test.

• Journal of Microbiology and Biotechnology
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• v.10 no.5
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• pp.707-713
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• 2000

Myasthenia gravis (MG) is caused mainly by autoantibodies directed against acetylcholine receptors located in the postsynaptic muscle cell membrane. Using in vitro selection techniques, we isolated an RNA containing 2'-fluoro pyrimidines that can specifically and avidly ($K_d$ ~25 nM) bind rat monoclonal antibody called mAb198, which recognizes the main immunogenic region on the acetylcholine receptors. This RNA can act as a very effective decoy and block mAb198 binding to the receptors in vitro. Furthermore, this RNA decoy can prevent the antigenic modulation of the acetylcholine receptor caused by mAb198 in human muscle cell cultures with and $IC_{50} $of approximately $2.4{\mu}M$. These results indicate that the RNA selected in this study is a more potent decly inhibitor of myashthenic antibodies than the previously identified RNA with 2'-amino pyrimidines [11]. Moreover, this RNA cross-reacts with autoantibodies from patients with MG and can protect human cells from the effects of these antibodies. These observations have important implications for developing an antigen-specific treatment of autoimmune diseases including MG, which is based on decoy RNAs selected in vitro.

• Korean Journal of Veterinary Research
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• v.46 no.1
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• pp.71-73
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• 2006

A 7-month-old female Shih-tzu dog was presented with intermittent trembling, dyspnea, generalized muscle weakness, and unconsciousness after exercise. No remarkable findings were shown in the complete blood counts and the radiographic examination. On serum biochemical profiles, alkaline phosphatase and creatine phosphokinase were mildly elevated. Based on history takings, physical examination, and neurological findings, presumptive diagnosis was made as a myasthenia gravis (MG). Clinical signs of this patient were dramatically improved after administration of neostigmine. The result of acetylcholine receptor antibody test in serum was 0.89 nmol/L and the histopathology of muscle were normal. Clinical sign of the patient evaluated in this study is stabilized with long-term administration of pyridostigmine at this time. This case report here describes clinical and clinicopathological findings of a juvenile onset acquired MG in a Shih-tzu dog.

• Annals of Clinical Neurophysiology
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• v.9 no.2
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• pp.51-58
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• 2007

Autoimmune myasthenia gravis (MG) is the neuromuscular junction disorder mostly caused by antibody against the acetylcholine receptor (AChR antibody) at the muscle endplate. The goal of treatment is to induce and maintain remission, i.e., absence of symptoms, with the least cost-to-benefit ratio. Although corticosteroids are effective in inducing remission in most patients, they have numerous potentially serious adverse effects with their long-term use. In addition, some patients do not respond or are intolerant to the conventional treatment. In this article, we discuss the difficulties encountered in long-term immunosuppressive treatment of MG, and review useful tips for the use of corticosteroids. Long-term immunosuppressive agents that can be used in steroid-refractory or -dependent patients will be reviewed with their safety profiles and efficacy in MG.

• Journal of Veterinary Clinics
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• v.22 no.4
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• pp.392-395
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• 2005

A three-year old intact female German shepherd dog weighing 32kg was presented with the history of regurgitation and vomiting. Physical examination revealed a thin body condition, hoarse voice, hypersalivation, and pelvic limb weakness. In radiograph, meagaesophagus was identified. The neostigmine challenge test was positive. The titer of acetylcholine receptor (AChR) antibody was 1.58 nmol/L (reference range, <0.6nmol). Therefore, the dog was diagnosed to be suffering with chronic generalized form of acquired myasthenia gravis and followed by treatment with pyridostigmine bromide, 1mg/kg, q12 hrs. Treatment improved the pelvic limb weakness, however intermittent regurgitation and vomiting persisted. This resulted in aspiration pneumonia f3r which antibiotics were administered However, the dog was euthanized due to poor management and owner's request.

• Annals of Clinical Neurophysiology
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• v.8 no.2
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• pp.203-205
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• 2006

There have been several reports about coexistence of myasthenia and other autoimmune disease. Psoriasis is a papulosquamous disease defined by erythematous plaques with a silvery scale and a T-cell-mediated autoimmune disease. We report a case of a 49-year-old man with generalized myasthenia gravis (MG) superimposed by psoriasis. MG was diagnosed by clinical symptoms, increased acetylcholine receptor antibody titer and repetitive nerve stimulation test. Psoriasis was diagnosed by clinical manifestations and specific skin biopsy findings. MG and psoriasis are both autoimmune diseases. The coexistence of MG and psoriasis suggest a close connection of pathogenesis.

• Journal of Veterinary Clinics
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• v.23 no.4
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• pp.465-468
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• 2006

A 3-year-old, spayed female Shih-tzu dog was presented due to acute vomiting, diarrhea, and generalized weakness. The dog had generalized weakness, increased respiratory rate, and respiratory muscle effect. Neurologic examination revealed appendicular muscular weakness and decreased in tone of the anal sphincter. Megaesophagus was confirmed by radiographic examinations. Other than type 2 fiber atrophy, no specific abnormalities were identified in histopathologic examinations of muscle biopsies from the left pelvic limb. Serum acetylcholine receptor (AChR) antibody titer was increased (0.78 nmol/L reference range, less than 0.6 nmol/L), confirming a diagnosis of acute fulminating myasthenia gravis. The dog dramatically responded to pyridostigmine bromide and had marked improvement in muscle strength, megaesophagus, and respiratory function. The dog has been successfully managed for 7 months after initial treatment.

• Journal of Veterinary Clinics
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• v.29 no.1
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• pp.107-111
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• 2012

Three dogs (An 8 years-old intact female Poodle, a 7 years-old intact male Schunauzer, and an 8 yearsold Golden Retriever) were presented due to acute vomiting, dyspnea, and generalized weakness. Megaesophagus was confirmed through radiographic examination in all 3 dogs. Relative oesophageal diameter (ROD) was measured and results of ROD measurements showed the possibility of megaesophagus secondary to myasthenia gravis in three dogs. Thus we performed anticholinesterase test as screening test for myasthenia gravis. In all three dogs, esophageal diameter was reduced after neostigmine methylsulfate administration. For definite diagnosis of acquired myasthenia gravis, serum acetylcholine receptor antibody titer was measured, but definite diagnosis was confirmed only in one case. However, based on history, radiographic findings, anticholinesterase test, ROD measurement, other two cases were still suspected as megaesophagus secondary to myasthenia gravis. Treatment with pyridostigmine bromide was initiated in all dogs, and improvement of esophageal diameter was shown in all dogs. One dog was successfully managed for 15 months after initial treatment and, is still alive, but other two dogs were died shortly after initial treatment, because of severe aspiration pneumonia.