Treating myasthenia gravis

December 24, 2010 3:08:15 PM PST
The holiday season has been particularly special for one grandmother who suddenly developed symptoms that no one seemed to be able to identify.

Marie McMillan could not even keep her eyes open, but after her successful treatment, was able to resume her traditional cooking and baking for her family.

McMillan loves Christmastime. Every year, she looks forward to her family's favorite activity - baking the holiday cookies.

But then some years ago, the symptoms began. Out of the blue, she couldn't chew. But then that symptoms went away.

Other came and went, including muscle weakness and drooping eyelids.

"It finally got so bad that I couldn't swallow," she said. "And I thought okay, that's something wrong."

At the University of Michigan Health Center, she was diagnosed with myasthenia gravis, an auto immune disorder where the communications between nerves and muscles are blocked.

"People end up developing weakness of the muscles of the face, of the throat and even breathing muscles, as well as the arm and leg muscles," Dr. Kirsten Gruis said.

Dr. Gruis says the disorder is under-diagnosed because symptoms can be intermittent and patients end up blaming symptoms on fatigue. Untreated, it will progress slowly.

Myasthenia gravis most often occurs in men over 60 and women under 40.

McMillan was also unusual in that she did not respond to normal therapy of steroids.

"Untreated, the disease will continue to progress, and patients will develop progressive fixed weakness," Dr. Gruis said.

Enter a new class of medications called biologics. One of these is called IVIG - for intravenous immunoglobulin. It was used to treat Marie.

"The immunoglobulin comes from pooled blood donors such that the immunoglobulin is separated from the blood and treated in a fashion so that it's useable to retrain the patient's immune system for disorders such as myasthenia gravis," Dr. Gruis said.

Marie responded almost immediately. She spent one day in a wheelchair, and two days later, she was walking. Now, she's back to baking her beloved cookies with her grandkids.

"We take so much for granted, and not anymore I don't," she said. "I'm just grateful that I'm still able to do everything I can do."


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