RESUMO
The presence of erythroblasts in the peripheral blood is generally associated with severe underlying disorders. The anti-very late antigen-4 (anti-VLA-4) antibody natalizumab, which is approved for treatment of multiple sclerosis, mediates an increase in circulating haematopoietic stem cells and may also trigger erythroblastaemia. We investigated the prevalence of erythroblastaemia in sequential blood smears of 14 natalizumab-treated and 14 interferon-treated patients with multiple sclerosis. Erythroblastaemia was found in 13 natalizumab-treated subjects (93%), whereas all controls were negative (p<0.0001). Knowledge of this frequent side effect is crucial for the correct interpretation of blood smears in natalizumab-treated patients and to avoid unnecessary diagnostic procedures.
Assuntos
Eritroblastos/efeitos dos fármacos , Doenças Hematológicas/induzido quimicamente , Fatores Imunológicos/efeitos adversos , Integrina alfa4beta1/antagonistas & inibidores , Esclerose Múltipla/tratamento farmacológico , Natalizumab/efeitos adversos , Adulto , Áustria/epidemiologia , Estudos de Casos e Controles , Feminino , Doenças Hematológicas/sangue , Doenças Hematológicas/diagnóstico , Doenças Hematológicas/epidemiologia , Humanos , Integrina alfa4beta1/imunologia , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/diagnóstico , Esclerose Múltipla/epidemiologia , Esclerose Múltipla/imunologia , Prevalência , Fatores de Risco , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Ocular myasthenia is a localised form of myasthenia clinically involving the extraocular muscles, the m. levator palpebrae superioris and the m. orbicularis oculi. Various symptoms can masquerade peripheral and supranuclear eye muscle palsies and ptosis. MATERIALS AND METHOD: This literature review of recent years focuses on the diagnostic tests that may be helpful to confirm myasthenia especially in patients without acetylcholine receptor antibodies. CONCLUSIONS: Ocular dysfunction accounts for 50-80% of the initial manifestation of myasthenia gravis. Clinical manifestations, diagnostic tests and treatment assessment are reviewed. Early recognition of the disease is important for better prognosis.
Assuntos
Miastenia Gravis/diagnóstico , Corticosteroides/uso terapêutico , Autoanticorpos/sangue , Diagnóstico Diferencial , Humanos , Imunização Passiva , Imunossupressores/uso terapêutico , Miastenia Gravis/imunologia , Miastenia Gravis/terapia , Plasmaferese , Receptores Colinérgicos/imunologia , Fatores de Risco , TimectomiaRESUMO
Levodopa is recommended as a therapeutic approach for patients with the hypokinetic-rigid, Westphal variant of Huntington's disease, but no guidelines are available for the case of nonrespondence to levodopa. In this study, however, we report a 34-year-old woman with this rare variant who showed a clear-cut improvement in motor function and depressive symptoms after treatment with pramipexole, a new dopamine agonist.
