Myasthenia Gravis: risk of infection in muscular patients
Myasthenia gravis (MG) is a serious neuromuscular autoimmune disease. Medicine uses immunosuppression or immunomodulating therapies to treat patients with this type of muscle disease. However, this can suppress or change the immune system, with infections being a major risk. Charles Kassardjian, neurologist and researcher at St. Michael Hospital, has published the largest study on the risk of infection in the field of neuromuscular medicine.
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Remarkably, there is almost no data from large cohorts that could help lead the discussion with patients about the infection risks associated with treatment despite the frequent use of immunosuppressants. Therefore there was a large knowledge gap. Because of this gap, the research results are new and exciting. So these are serious risks that patients must be aware of. However, there are no specific guidelines for neuromuscular diseases. However, these can help clinicians to assess the risk or opt for preventive antibiotics.
About a third of the patients in the study developed a severe infection during the study period. After adjusting for confusing variables, the scientists found that patients with muscle problems were 39 percent more likely to develop a serious infection. The most common of these were respiratory infections, such as pneumonia. There were, among other things, increased rates of skin infections, sepsis, post-operative infections, shingles and influenza.
This study provides physicians with real-world data that they can use to inform their patients about infection risks and the most likely infections. In addition, muscle weakness is a disease that is treated not only by neuromuscular specialists, but also by general neurologists and internists and, of course, with the active participation of family doctors. Therefore, the results are of interest and applicable to a large audience of clinicians.
Although the scientists haven't studied any other diseases, the results increase the possibility of infection risk in other autoimmune neurological diseases that use immunosuppression. Hopefully this will stimulate further studies. Finally, there are some important practical implications. For example, the higher influenza and shingles rates in the study suggest that doctors should consider vaccinating these entities in patients with muscle problems.
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