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Myasthenia, limb-girdle, autoimmune

MedGen UID:
331795
Concept ID:
C1834635
Disease or Syndrome
Synonym: MYASTHENIA GRAVIS, LIMB-GIRDLE
 
Monarch Initiative: MONDO:0008036
OMIM®: 159400

Clinical features

From HPO
Neoplasm
MedGen UID:
10294
Concept ID:
C0027651
Neoplastic Process
An organ or organ-system abnormality that consists of uncontrolled autonomous cell-proliferation which can occur in any part of the body as a benign or malignant neoplasm (tumor).
Thymoma
MedGen UID:
52743
Concept ID:
C0040100
Neoplastic Process
A tumor originating from the epithelial cells of the thymus.
Fatigable weakness
MedGen UID:
451076
Concept ID:
C0947912
Disease or Syndrome
A type of weakness that occurs after a muscle group is used and lessens if the muscle group has some rest. That is, there is diminution of strength with repetitive muscle actions.
Proximal amyotrophy
MedGen UID:
342591
Concept ID:
C1850794
Disease or Syndrome
Amyotrophy (muscular atrophy) affecting the proximal musculature.
Type 2 muscle fiber atrophy
MedGen UID:
355249
Concept ID:
C1864580
Pathologic Function
Atrophy (wasting) affecting primary type 2 muscle fibers. This feature in general can only be observed on muscle biopsy.
EMG: decremental response of compound muscle action potential to repetitive nerve stimulation
MedGen UID:
892749
Concept ID:
C4021728
Finding
A compound muscle action potential (CMAP) is a type of electromyography (EMG). CMAP refers to a group of almost simultaneous action potentials from several muscle fibers in the same area evoked by stimulation of the supplying motor nerve and are recorded as one multipeaked summated action potential. This abnormality refers to a greater than normal decrease in the amplitude during the course of the investigation.
Systemic lupus erythematosus
MedGen UID:
6146
Concept ID:
C0024141
Disease or Syndrome
Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by production of autoantibodies against nuclear, cytoplasmic, and cell surface molecules that transcend organ-specific boundaries. Tissue deposition of antibodies or immune complexes induces inflammation and subsequent injury of multiple organs and finally results in clinical manifestations of SLE, including glomerulonephritis, dermatitis, thrombosis, vasculitis, seizures, and arthritis. Evidence strongly suggests the involvement of genetic components in SLE susceptibility (summary by Oishi et al., 2008). Genetic Heterogeneity of Systemic Lupus Erythematosus An autosomal recessive form of systemic lupus erythematosus (SLEB16; 614420) is caused by mutation in the DNASE1L3 gene (602244) on chromosome 3p14.3. An X-linked dominant form of SLE (SLEB17; 301080) is caused by heterozygous mutation in the TLR7 gene (300365) on chromosome Xp22. See MAPPING and MOLECULAR GENETICS sections for a discussion of genetic heterogeneity of susceptibility to SLE.
Hashimoto thyroiditis
MedGen UID:
151769
Concept ID:
C0677607
Disease or Syndrome
Hashimoto's disease is a condition that affects the function of the thyroid, which is a butterfly-shaped gland in the lower neck. The thyroid makes hormones that help regulate a wide variety of critical body functions. For example, thyroid hormones influence growth and development, body temperature, heart rate, menstrual cycles, and weight. Hashimoto's disease is a form of chronic inflammation that can damage the thyroid, reducing its ability to produce hormones.\n\nOne of the first signs of Hashimoto's disease is an enlargement of the thyroid called a goiter. Depending on its size, the enlarged thyroid can cause the neck to look swollen and may interfere with breathing and swallowing. As damage to the thyroid continues, the gland can shrink over a period of years and the goiter may eventually disappear.\n\nOther signs and symptoms resulting from an underactive thyroid can include excessive tiredness (fatigue), weight gain or difficulty losing weight, hair that is thin and dry, a slow heart rate, joint or muscle pain, and constipation. People with Hashimoto's disease may also have a pale, puffy face and feel cold even when others around them are warm. Affected women can have heavy or irregular menstrual periods and difficulty conceiving a child (impaired fertility). Difficulty concentrating and depression can also be signs of a shortage of thyroid hormones.\n\nHashimoto's disease usually appears in mid-adulthood, although it can occur earlier or later in life. Its signs and symptoms tend to develop gradually over months or years.
Mildly elevated creatine kinase
MedGen UID:
342469
Concept ID:
C1850309
Finding
Ptosis
MedGen UID:
2287
Concept ID:
C0005745
Disease or Syndrome
The upper eyelid margin is positioned 3 mm or more lower than usual and covers the superior portion of the iris (objective); or, the upper lid margin obscures at least part of the pupil (subjective).
Ophthalmoparesis
MedGen UID:
155551
Concept ID:
C0751401
Sign or Symptom
Ophthalmoplegia is a paralysis or weakness of one or more of the muscles that control eye movement.

Recent clinical studies

Etiology

Rodolico C, Parisi D, Portaro S, Biasini F, Sinicropi S, Ciranni A, Toscano A, Messina S, Musumeci O, Vita G, Girlanda P
J Neuromuscul Dis 2016 Aug 30;3(3):413-418. doi: 10.3233/JND-160148. PMID: 27854225

Diagnosis

Vecchio D, Varrasi C, Comi C, Ripellino P, Cantello R
Clin Neurol Neurosurg 2017 Jul;158:53-55. Epub 2017 Apr 23 doi: 10.1016/j.clineuro.2017.04.016. PMID: 28460343
Rodolico C, Parisi D, Portaro S, Biasini F, Sinicropi S, Ciranni A, Toscano A, Messina S, Musumeci O, Vita G, Girlanda P
J Neuromuscul Dis 2016 Aug 30;3(3):413-418. doi: 10.3233/JND-160148. PMID: 27854225

Therapy

Maselli RA, Arredondo J, Nguyen J, Lara M, Ng F, Ngo M, Pham JM, Yi Q, Stajich JM, McDonald K, Hauser MA, Wollmann RL
Clin Genet 2014 Feb;85(2):166-71. Epub 2013 Mar 11 doi: 10.1111/cge.12118. PMID: 23488891

Prognosis

Selcen D, Ohkawara B, Shen XM, McEvoy K, Ohno K, Engel AG
JAMA Neurol 2015 Aug;72(8):889-96. doi: 10.1001/jamaneurol.2015.0853. PMID: 26052878Free PMC Article

Clinical prediction guides

Selcen D, Ohkawara B, Shen XM, McEvoy K, Ohno K, Engel AG
JAMA Neurol 2015 Aug;72(8):889-96. doi: 10.1001/jamaneurol.2015.0853. PMID: 26052878Free PMC Article

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