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颈椎调整后重症肌无力的缓解

Remission of myasthenia gravis following cervical adjustment.

作者信息

Chu Eric Chun Pu, Bellin David

机构信息

New York Chiropractic and Physiotherapy Centre, New York Medical Group, Hong Kong, China.

出版信息

AME Case Rep. 2019 Apr 22;3:9. doi: 10.21037/acr.2019.04.04. eCollection 2019.

Abstract

Myasthenia gravis (MG) is an autoimmune disorder, caused by circulating antibodies against the acetylcholine receptor (AChR) and associated proteins. Anticholinesterase medications and immunomodulating therapies are the mainstays of current treatment. Presented here is a case of a 51-year-old female who had been diagnosed with MG based on symptoms and continued elevation of antibody to AChR (anti-AChR) by her family physician. The patient's anticholinesterase medication was halted due to significant side effects affecting bowel function. She only received acupuncture treatment in the past 4 months prior to this presentation. Myasthenic symptoms deteriorated and the anti-AChR titer kept elevating after stopping medication. She originally came to us due to neck and back pain rather than myasthenic complaints. This case is interesting that her back pain and myasthenic symptoms went into complete remission within 1 month of initiating chiropractic adjustment. The concomitant recession of the myasthenic symptoms raises considerable interest for the mystery of MG, including the causal link between stress and autoimmune disease, the role of ACh in immune regulation, and the possible mechanisms of disease amelioration. Further studies would shed more light on the efficacy of various modalities in treating MG.

摘要

重症肌无力(MG)是一种自身免疫性疾病,由针对乙酰胆碱受体(AChR)及相关蛋白的循环抗体引起。抗胆碱酯酶药物和免疫调节疗法是目前治疗的主要手段。本文介绍了一例51岁女性病例,其家庭医生根据症状及抗AChR抗体(抗AChR)持续升高诊断为MG。由于影响肠道功能的严重副作用,该患者的抗胆碱酯酶药物被停用。在此次就诊前的4个月里,她仅接受了针灸治疗。停药后,肌无力症状恶化,抗AChR滴度持续升高。她最初因颈部和背部疼痛前来就诊,而非肌无力相关主诉。该病例有趣之处在于,在开始整脊调整后的1个月内,她的背痛和肌无力症状完全缓解。肌无力症状的同时缓解引发了人们对MG奥秘的浓厚兴趣,包括压力与自身免疫性疾病之间的因果联系、ACh在免疫调节中的作用以及疾病改善的可能机制。进一步的研究将更清楚地揭示各种治疗方式对MG的疗效。

相似文献

1
Remission of myasthenia gravis following cervical adjustment.颈椎调整后重症肌无力的缓解
AME Case Rep. 2019 Apr 22;3:9. doi: 10.21037/acr.2019.04.04. eCollection 2019.
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[Antibodies in myasthenia gravis].[重症肌无力中的抗体]
Rev Neurol (Paris). 2009 Feb;165(2):137-43. doi: 10.1016/j.neurol.2008.11.020. Epub 2009 Jan 21.
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Immunology of the acetylcholine receptor.乙酰胆碱受体的免疫学
Immunol Commun. 1976;5(4):323-44. doi: 10.3109/08820137609044283.
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Myasthenia gravis and myasthenic syndromes.重症肌无力和肌无力综合征。
Ann Neurol. 1984 Nov;16(5):519-34. doi: 10.1002/ana.410160502.

本文引用的文献

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The non-neuronal cholinergic system in health and disease.非神经胆碱能系统在健康和疾病中的作用。
Pharmacology. 2013;92(5-6):286-302. doi: 10.1159/000355835. Epub 2013 Nov 29.

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