Question
21 year old female presents with history of this condition as shown in image, proximal muscle weakness and easy fatiguability. Which amongst the following, is best in diagnosing this condition
A. Rheumatoid factor
B. Anti–acetylcholine receptor antibody
C. Antinuclear Antibody
D. Thyroid function tests
Show Answer
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Correct Answer » B
Explanation
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Ans:B. Anti–acetylcholine receptor antibody
The patient is suffering from Myasthenia Gravis with bilateral ptosis.
Myasthenia gravis
- It is an autoimmune disorder of neuromuscular transmission in which antibodies form against acetylcholine nicotinic postsynaptic receptors at the neuromuscular junction of skeletal muscles.
- Women are more often affected than men.
- The usual initial complaint is a specific muscle weakness rather than generalized weakness
- Extraocular muscle weakness or ptosis is present initially in 50% of patients and occurs during the course of illness in 90%.
- Weakness tends to spread from the ocular to facial to bulbar muscles and then to truncal and limb muscles.
- Limb weakness may be more severe proximally than distally.
- Weakness is typically least severe in the morning and worsens as the day progresses.
- Weakness is increased by exertion and alleviated by rest.
- The anti–acetylcholine receptor (AChR) antibody (Ab) test is reliable for diagnosing autoimmune myasthenia gravis
- Therapy for MG includes the following:
- Anticholinesterase (AchE) inhibitors
- Immunomodulating agents
- Intravenous immune globulin (IVIg)
- Plasmapheresis
- Thymectomy
