Auto-immune myasthenia, care and treatment

Abstract

Although considered as rare, generalized autoimmune myasthenia (GM) is the most frequent neuromuscular junction disease. GM only involves skeletal muscles. The cardinal signs are muscular fatigability during effort and fluctuation. GM is a chronic disease leading to acute episodes requiring admission to the intensive care unit and endotracheal intubation. Severity is mainly due to the impairment of respiratory and swallowing muscles which should be early detected. Nurses should be aware of these GM-related features. Treatment is supportive including mechanical ventilation. Immunomodulatory therapies including intravenous immunoglobulins and plasma exchanges have been shown efficient to reverse the course of GMcrisis. Corticosteroids in association with an immunosuppressive drug are generally required to stabilize the disease on a long-term. Thymectomy should be considered in the presence of thymus abnormalities.