Psychosocial aspects of myasthenia gravis
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33 FETAL ACETYLCHOLINE RECEPTOR FUNCTION REDUCED BY SERUM FROM ASYMPTOMATIC MOTHER WITH HISTORY OF FETAL ARTHROGRYPOSIS. Angela Vincent, Sietske Riemersma, Simon Hawke, John Newsom-Davis, Louise Brueton'. Neurosciences Group, Institute of Molecular Medicine, John Radcliffe Hospital, Oxford OX3 9DU and "Kennedy Galton Centre, Northwick Park, Middlesex. Out of 30 infants born to MG mothers (Morel et al 1988), 10 infants had typical neonatal myasthenia gravis without fetal abnormality, but a further four were born, after premature Caesarian delivery for reduced fetal activity, with multiple flexion contractures (arthrogryposis) and hypotonia. It was suggested that anti-AChR antibodies specific for fetal AChR might be responsible for the vulnerability of the fetus to neonatal MG. In a more recent case (Barnes et al 1994), the diagnosis of MG in the mother was not made until after the birth of the fourth affected infant. The maternal anti-AChR titre, measured after the fourth delivery, was 609nM. Because of the possibilty that the diagnosis of MG might be missed in similar cases, we have looked for serum anti-AChR antibodies in serum from 29 mothers with a history of fetal arthrogryposis. 28 sera were negative. In one asymptomatic 31 yr old with five previously affected fetuses, anti-AChR antibody was 57.0 nM. Moreover, the serum inhibited AChR function in the muscle cell line TE671, that expresses fetal AChR, by over 90% even at high serum dilutions (1:1000). Thus a high concentration of antibodies directed against functional domains on the fetal AChR may explain the presence of severe fetal abnormalities in the absence of maternal symptoms; similar antibodies may contribute to the development of arthrogryposis in other cases. St9 34 P s y ch o s o c i a 1 a s p e c t s o f g r a v i s Josipa Gazibara, Marija Zagar, Anica Jugi~ Mya s t he n i a About 15 years ago the hypothesis was created that the virus, neoplasm or psychological stress may be the factors damaging the Ach-receptors of thymic myoid cells and this way creating the primary antigen. In actual research we concentrated ourselves on psychosocial issues. The analysis was performed by means of specially constructed questionnary with answers defined by "yes", "no" or "no answer" so that the precise quantitative assesment could be done. The study is in progress. The preliminary results already point to high correlation of psycological distress with the illness beginn or worsening. The autogenic training courses were started. The social structure of diseased has no specific profile. All social levels may be involved, in city or in countryside.
Transcript of Psychosocial aspects of myasthenia gravis
33 FETAL ACETYLCHOLINE RECEPTOR FUNCTION REDUCED BY SERUM FROM ASYMPTOMATIC MOTHER WITH HISTORY OF FETAL ARTHROGRYPOSIS. Angela Vincent, Sietske Riemersma, Simon Hawke, John Newsom-Davis, Louise Brueton'. Neurosciences Group, Institute of Molecular Medicine, John Radcliffe Hospital, Oxford OX3 9DU and "Kennedy Galton Centre, Northwick Park, Middlesex.
Out of 30 infants born to MG mothers (Morel et al 1988), 10 infants had typical neonatal myasthenia gravis without fetal abnormality, but a further four were born, after premature Caesarian delivery for reduced fetal activity, with multiple flexion contractures (arthrogryposis) and hypotonia. It was suggested that anti-AChR antibodies specific for fetal AChR might be responsible for the vulnerability of the fetus to neonatal MG. In a more recent case (Barnes et al 1994), the diagnosis of MG in the mother was not made until after the birth of the fourth affected infant. The maternal anti-AChR titre, measured after the fourth delivery, was 609nM. Because of the possibilty that the diagnosis of MG might be missed in similar cases, we have looked for serum anti-AChR antibodies in serum from 29 mothers with a history of fetal arthrogryposis. 28 sera were negative. In one asymptomatic 31 yr old with five previously affected fetuses, anti-AChR antibody was 57.0 nM. Moreover, the serum inhibited AChR function in the muscle cell line TE671, that expresses fetal AChR, by over 90% even at high serum dilutions (1:1000). Thus a high concentration of antibodies directed against functional domains on the fetal AChR may explain the presence of severe fetal abnormalities in the absence of maternal symptoms; similar antibodies may contribute to the development of arthrogryposis in other cases.
St9
34 P s y ch o s o c i a 1 a s p e c t s o f g r a v i s Josipa Gazibara, Marija Zagar, Anica Jugi~
Mya s t he n i a
About 15 years ago the hypothesis was created that the virus, neoplasm or psychological stress may be the factors damaging the Ach-receptors of thymic myoid cells and this way creating the primary antigen. In actual research we concentrated ourselves on psychosocial issues.
The analysis was performed by means of specially constructed questionnary with answers defined by "yes", "no" or "no answer" so that the precise quantitative assesment could be done. The study is in progress. The preliminary results already point to high correlation of psycological distress with the illness beginn or worsening.
The autogenic training courses were started.
The social structure of diseased has no specific profile. All social levels may be involved, in city or in countryside.
