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重症肌无力与感染性疾病。

Myasthenia gravis and infectious disease.

机构信息

Department of Clinical Medicine, University of Bergen, Bergen, Norway.

Department of Neurology, Haukeland University Hospital, 5021, Bergen, Norway.

出版信息

J Neurol. 2018 Jun;265(6):1251-1258. doi: 10.1007/s00415-018-8751-9. Epub 2018 Jan 25.

Abstract

BACKGROUND AND PURPOSE

Myasthenia gravis (MG) is an autoimmune disease with muscular weakness as the only symptom, and often with immunosuppressive treatment. All these aspects could have relevance for the risk of infections as well as their prophylactic and curative treatment.

METHODS

This is a review article, where Web of Science has been searched for relevant key words and key word combinations. Full papers were selected first by title and then by abstract.

RESULTS AND CONCLUSIONS

MG can be triggered and worsened by infections. No virus or other pathogen has been proven to have a specific link to MG. Treatment with immunosuppressive drugs and thymectomy implies a slightly increased risk for infections. Infections should be actively treated, but a few antibiotics are avoided due to potential interference with neuromuscular transmission. Hospitalization and intensive care may be necessary during infections because of MG deterioration and risk of insufficient respiration. Vaccinations are generally recommended in MG, but live microorganisms should be avoided if possible in immunosuppressed patients.

摘要

背景与目的

重症肌无力(MG)是一种以肌肉无力为唯一症状的自身免疫性疾病,常采用免疫抑制治疗。所有这些方面都可能与感染风险以及感染的预防和治疗相关。

方法

这是一篇综述文章,在 Web of Science 上检索了相关的关键词和关键词组合。首先根据标题选择全文,然后根据摘要进行选择。

结果与结论

MG 可由感染引发或加重。没有病毒或其他病原体被证明与 MG 有特定的联系。免疫抑制药物治疗和胸腺切除术会略微增加感染的风险。应积极治疗感染,但由于可能干扰神经肌肉传递,应避免使用一些抗生素。由于 MG 恶化和呼吸不足的风险,感染期间可能需要住院和重症监护。MG 患者一般建议接种疫苗,但如果可能的话,应避免免疫抑制患者使用活微生物。

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