Relatives of people with MG have a higher percentage of other immune disorders. [22] [23] The thymus gland cells form part of the body's immune system. ... Acutely, negative inspiratory force may be used to determine adequacy of ventilation; it is performed on those individuals with MG. [40] [41] Management [ edit ] Treatment is by medication and/or surgery. Medication consists mainly of acetylcholinesterase inhibitors to directly improve muscle function and immunosuppressant drugs to reduce the autoimmune process. [42] Thymectomy is a surgical method to treat MG. [43] Medication [ edit ] Neostigmine, chemical structure Azathioprine, chemical structure Worsening may occur with medication such as fluoroquinolones , aminoglycosides , and magnesium. [44] About 10% of people with generalized MG are considered treatment-refractory. [45] Autologous hematopoietic stem cell transplantation (HSCT) is sometimes used in severe, treatment-refractory MG. ... Both of these treatments have relatively short-lived benefits, typically measured in weeks, and often are associated with high costs, which make them prohibitive; they are generally reserved for when MG requires hospitalization. [49] [52] Surgery [ edit ] As thymomas are seen in 10% of all people with the MG, they are often given a chest X-ray and CT scan to evaluate their need for surgical removal of their thymus glands and any cancerous tissue that may be present. [18] [37] Even if surgery is performed to remove a thymoma, it generally does not lead to the remission of MG. [49] Surgery in the case of MG involves the removal of the thymus, although in 2013, no clear benefit was indicated except in the presence of a thymoma. [53] A 2016 randomized, controlled trial, however, found some benefits. [54] Physical measures [ edit ] People with MG should be educated regarding the fluctuating nature of their symptoms, including weakness and exercise-induced fatigue. ... Prevalence in the United States is estimated at between 0.5 and 20.4 cases per 100,000, with an estimated 60,000 Americans affected. [18] [58] Within the United Kingdom, an estimated 15 cases of MG occur per 100,000 people. [37] History [ edit ] The first to write about MG were Thomas Willis , Samuel Wilks, Erb, and Goldflam. [14] The term "myasthenia gravis pseudo-paralytica" was proposed in 1895 by Jolly, a German physician. [14] Mary Walker treated a person with MG with physostigmine in 1934. [14] Simpson and Nastuck detailed the autoimmune nature of the condition. [14] In 1973, Patrick and Lindstrom used rabbits to show that immunization with purified muscle-like acetylcholine receptors caused the development of MG-like symptoms. [14] Research [ edit ] Immunomodulating substances, such as drugs that prevent acetylcholine receptor modulation by the immune system, are currently being researched. [59] Some research recently has been on anti-c5 inhibitors for treatment research as they are safe and used in the treatment of other diseases. [60] Ephedrine seems to benefit some people more than other medications, but it has not been properly studied as of 2014. [7] [61] In the laboratory, MG is mostly studied in model organisms, such as rodents.
