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Diagnostic and therapeutic challenges of Myasthenia Gravis: A report of 2 cases

100%
Poleszak J., Szabat P., Jasielski P., Szabat M., Petit V., Fidor A., Rejdak K.
World News of Natural Sciences
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2020
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vol. 31
138-145
EN
Myasthenia gravis (MG) is an autoimmune disease that affects the neuromuscular junction and is characterized by muscle weakness. We present two clinical cases of patients with MG. The first case of the patient presents an uncharacteristic clinical picture in the form of dyspnoea with stridor. The second clinical case presents a severe form of MG, resistant to pharmacological cholinergic and immunosuppressive treatment, which resulted in a satisfactory improvement after eight plasmapheresis treatments and the conversion of pyridostigmine to the ambenonium.
2
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The role of nuclear factor-κB in the development of autoimmune diseases: a link between genes and environment

100%
Kuryłowicz A., Nauman J.
|
2008
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vol. 55
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issue 4
629-647
EN
Although autoimmune diseases are relatively common, mechanisms that lead to their development remain largely unknown. Nuclear factor-κB (NF-κB), as a key transcription factor involved in the regulation of immune responses and apoptosis, appears to be a good candidate for studies on the pathogenesis of autoimmunity. This review presents how perturbations of the NF-κB signaling pathway may contribute to self-tolerance failure, initiation of autoimmune inflammatory response as well as its persistent maintenance and therefore to the development of common autoimmune diseases including rheumatoid arthritis, multiple sclerosis, type 1 diabetes mellitus, thyroid autoimmune diseases, systemic lupus erythematosus as well as inflammatory bowel diseases and psoriasis. A special emphasis is put on the genetic variations in the NF-κB related genes and their possible association with susceptibility to autoimmune diseases, as well as on the therapeutic potential of the NF-κB targeted strategies in the treatment of autoimmunity.
3
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An additional ultrasonographic sign of Hashimoto’s lymphocytic thyroiditis in children

63%
Kosiak W., Piskunowicz M., Świętoń D., Batko T., Kaszubowski M.
Journal of Ultrasonography
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2015
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vol. 15
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issue 63
349-357
EN
We present an additional sonographic sign of Hashimoto’s thyroiditis (HLT), increasing the specificity of this method in pediatric populations. Methods: A total of 98 children (mean age 12.7 years, range 7–17 years) were selected from the registry of the endocrinology outpatient department. All subjects met the diagnostic criteria for HLT. All children underwent a prospective thyroid ultrasound examination with special attention paid to the presence of lymph nodes adjacent to the thyroid gland. In order to form a control group, we analyzed 102 healthy volunteers and 94 children with cervical lymphadenopathy, age- and sex-matched with the main study group. Results: The ultrasound of the thyroid revealed typical sonographic signs of autoimmune thyroid disease in all children with HLT and in none of the individuals in the control groups. In 96 children (98%) from the HLT group, at least 2 lymph nodes adjacent to the lower part of the thyroid gland lobes localized on one or both sides of the thyroid were detected. No lymph nodes adjacent to the lower part of the thyroid lobes were found in healthy children or children with cervical lymphadenopathy. Conclusions: Lymph nodes adjacent to the lower part of the thyroid lobes are an additional ultrasound sign of pediatric Hashimoto’s lymphocytic thyroiditis, with 98% sensitivity and 100% specificity.
PL
W niniejszej pracy została przedstawiona dodatkowa cecha ultrasonograficzna przewlekłego limfocytowego zapalenia tarczycy, zwiększająca specyficzność tej metody w populacji dzieci. Materiał i metody: Z rejestru kliniki endokrynologii wybrano 98 dzieci (średnia wieku: 12,7 roku, przedział wiekowy: 7–17 lat). Wszyscy pacjenci spełniali kryteria diagnostyczne choroby Hashimoto. Każde dziecko poddano prospektywnemu badaniu ultrasonograficznemu tarczycy ze szczególnym uwzględnieniem występowania węzłów chłonnych przylegających do tarczycy. W celu utworzenia grupy kontrolnej analizie poddano 102 zdrowych ochotników oraz 94 dzieci z limfadenopatią szyjną, dopasowanych pod względem wieku i płci do badanej grupy. Wyniki: Badanie ultrasonograficzne tarczycy ujawniło typowe cechy sonograficzne autoimmunologicznej choroby tarczycy u wszystkich dzieci z chorobą Hashimoto i nie ujawniło ich u żadnego pacjenta z grupy kontrolnej. U 96 chorych dzieci (98%) wykryto co najmniej dwa węzły chłonne przylegające do dolnej części płatów tarczycy, umiejscowione z jednej lub z dwóch stron gruczołu. Nie wykryto węzłów chłonnych przylegających do dolnej części płatów tarczycy u dzieci zdrowych ani u dzieci z limfadenopatią szyjną. Wnioski: Występowanie węzłów chłonnych przylegających do dolnej części płatów tarczycy stanowi dodatkową cechę ultrasonograficzną zapalenia tarczycy Hashimoto u dzieci, wykazującą 98-procentową czułość i 100-procentową specyficzność.
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