OBJECTIVE We wished to study alterations in serum insulin-like growth factor-I (IGF-I) and its binding proteins in subjects with insulin dependent diabetes mellitus (IDDM) and possible relations with metabolic and GH secretory status, before and after cholinergic modulation. In addition, we have investigated whether cholinergic modulation exerts any effects on IGF-I secretion, independently of ...

late-onset cases, has yet to be clarified.' 2 Olanow et al.3 reported excellent results with thymectomy in 12 patients with late-onset myasthenia gravis. One of these had a thymolipoma. This tumour has, to our knowledge, only been reported in the world literature as a cause for myasthenia gravis in two other cases.4 ' We therefore present the fourth case in this paper. In May 1980 a 61-year-old...

Myasthenia Gravis is an autoimmune neuromuscular disorder of skeletal muscles due to the presence of acetylcholine receptor antibodies. Myasthenic patients are resistant to depolarizing relaxants such as succinylcholine but are very sensitive to non-depolarizing muscle relaxants1. That’s why, narcotic-based technique for induction and maintenance of anesthesia without muscle relaxants has been ...

We present the case of a 54-year-old female with longstanding history of myasthenia gravis, on whom an anti ACH antibody test was positive. We performed a minimally invasive video-assisted thoracoscopic thymectomy (VATS) on this patient. Preoperatively, the patient was stabilized with intravenous immunoglobulin (IVIG) and Mestinon (Pyridostigmine). The pre-operative workup included a computed t...

BACKGROUND The stiff person syndrome (SPS) is a rare disorder characterized by muscular rigidity and stiffness. CASE PRESENTATIONS We describe an SPS patient presenting with longstanding fatigue and electrophysiological evidence of presynaptic neuromuscular transmission defect, who responded to administration of pyridostigmine. In contrast, no electrophysiolgical evidence of neuromuscular tra...

A small proportion of thymoma patients without myasthenia gravis (MG) have been observed to develop MG after total removal of the thymoma. However, the underlying cause is not yet known due to the rarity of postoperative MG patients. We report a 39-year-old man in whom MG appeared after surgical removal of a thymoma. Computed tomography and magnetic resonance imaging showed no signs of recurren...

This is a case of a patient who presented with generalised weakness, dysphagia and ptosis. Upon evaluating the patient, she was found to have myasthenia gravis (MG) with anaemia and hypothyroidism. Further evaluation for the cause of anaemia revealed that the patient had pure red cell aplasia (PRCA). CT thorax revealed a thymoma. The patient was given packed cell transfusions, steroids and pyri...

Pyridostigmine bromide is a carbamate AChE inhibitor with a positively charged “quaternary ammonium” group, which is believed to prevent its penetration through the “blood-brain barrier,” a layer of cells that controls which substances may penetrate from the general circulation into the brain. Therefore, side effects of PB are typically those of heightened peripheral cholinergic activity (nicot...