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• W4285384799 abstract "Chika E Uzoigwe and Frederick Campbell-Jones1Uzoigwe CE Campbell-Jones F Antibiotic neuromuscular junction myasthenic mimetics.Lancet Neurol. 2022; 21: 681Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar highlight an important issue in medical practice for managing patients with neuromuscular autoimmune disease, and their remarks are a useful addition to our Review in the Series. Indeed, the use of particular antibiotics, muscle relaxants, and other drugs are known to worsen the disease in patients with myasthenia gravis or Lambert-Eaton myasthenic syndrome. Uzoigwe and Campbell-Jones mention gentamycin-loaded bone cement as a possible under-recognised source among these aggravating drugs.Many drugs are associated with worsening of signs and symptoms in patients with myasthenia gravis or Lambert-Eaton myasthenic syndrome. However, reported associations do not necessarily mean these drugs should never be prescribed for patients with these conditions. Reports of disease worsening are often rare or might represent a coincidental association. Clinical judgment and the cost-benefit ratio of a drug should be considered when that drug is deemed important for the treatment of a patient with myasthenia gravis or Lambert-Eaton myasthenic syndrome.2Narayanaswami P Sanders DB Wolfe G et al.International consensus guidance for management of myasthenia gravis: 2020 update.Neurology. 2021; 96: 114-122Crossref PubMed Scopus (95) Google Scholar Chika E Uzoigwe and Frederick Campbell-Jones1Uzoigwe CE Campbell-Jones F Antibiotic neuromuscular junction myasthenic mimetics.Lancet Neurol. 2022; 21: 681Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar highlight an important issue in medical practice for managing patients with neuromuscular autoimmune disease, and their remarks are a useful addition to our Review in the Series. Indeed, the use of particular antibiotics, muscle relaxants, and other drugs are known to worsen the disease in patients with myasthenia gravis or Lambert-Eaton myasthenic syndrome. Uzoigwe and Campbell-Jones mention gentamycin-loaded bone cement as a possible under-recognised source among these aggravating drugs. Many drugs are associated with worsening of signs and symptoms in patients with myasthenia gravis or Lambert-Eaton myasthenic syndrome. However, reported associations do not necessarily mean these drugs should never be prescribed for patients with these conditions. Reports of disease worsening are often rare or might represent a coincidental association. Clinical judgment and the cost-benefit ratio of a drug should be considered when that drug is deemed important for the treatment of a patient with myasthenia gravis or Lambert-Eaton myasthenic syndrome.2Narayanaswami P Sanders DB Wolfe G et al.International consensus guidance for management of myasthenia gravis: 2020 update.Neurology. 2021; 96: 114-122Crossref PubMed Scopus (95) Google Scholar See appendix for declarations of interest. Supplementary Material Download .pdf (.12 MB) Help with pdf files Supplementary appendix Download .pdf (.12 MB) Help with pdf files Supplementary appendix Antibiotic neuromuscular junction myasthenic mimeticsMaartje G Huijibers and colleagues1 are to be commended for their instructive and comprehensive Review of autoimmune neuromuscular junction disease. However, they do not discuss antibiotics that mimic some of the mechanisms of autoimmune neuromuscular junction disease and can therefore exacerbate the clinical features of neuromuscular myasthenic syndromes. International consensus guidance on the management of myasthenia gravis2 advises against the use of aminoglycosides, macrolides, and fluoroquinolones in people with myasthenia gravis and advocates for raising awareness of the potentially serious adverse reactions of these antibiotics in patients with this autoimmune neuromuscular myasthenic syndrome. Full-Text PDF Advances in the understanding of disease mechanisms of autoimmune neuromuscular junction disordersMuscle weakness and fatigue are the hallmarks of autoimmune neuromuscular junction disorders. Although a plethora of immunosuppressive treatments exist, no cure is available to date and many patients are left with debilitating muscle weakness. Recent advances in the understanding of the structure and function of the neuromuscular junction, and the development of novel in vitro and in vivo models, have been instrumental in unravelling the pathophysiology of these autoimmune diseases. These advances are providing the rationale for the development of new therapeutic strategies. Full-Text PDF" @default.
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• W4285384799 date "2022-08-01" @default.
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• W4285384799 title "Antibiotic neuromuscular junction myasthenic mimetics – Authors' reply" @default.
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• W4285384799 doi "https://doi.org/10.1016/s1474-4422(22)00265-4" @default.
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