Tuberculosis in pediatrics

Symptoms

• Muscle weakness that worsens with activity and improves with rest
• Drooping eyelids (ptosis)
• Double vision (diplopia)
• Difficulty speaking, swallowing, or breathing
• Weakness in arms and legs
• Difficulty walking or climbing stairs
• Drooping head or neck
• Difficulty holding up the head

Diagnosis

• Medical history and physical examination
• Blood tests:
  • Acetylcholine receptor antibody test
  • Muscle-specific kinase (MuSK) antibody test
• Electromyography (EMG) to measure muscle activity
• Repetitive nerve stimulation test to assess muscle fatigue
• Imaging tests (e.g., CT or MRI) to rule out other conditions
• Edrophonium test (Tensilon test) to diagnose myasthenia gravis

Treatment Options

• Medications:
  • Acetylcholinesterase inhibitors (e.g., pyridostigmine)
  • Immunosuppressive medications (e.g., prednisone, azathioprine)
  • Monoclonal antibodies (e.g., eculizumab)
• Plasmapheresis to remove antibodies from the blood
• Intravenous immunoglobulin (IVIG) to reduce antibody production
• Thymectomy (surgical removal of the thymus gland) for some patients
• Respiratory support with mechanical ventilation if necessary

Lifestyle Management

• Rest and avoid fatigue
• Take regular breaks to rest muscles
• Avoid stress and anxiety
• Maintain a healthy diet and stay hydrated
• Exercise regularly, but avoid overexertion
• Get enough sleep and practice good sleep hygiene
• Avoid extreme temperatures and humidity

Pathophysiology

• Autoimmune disorder where the immune system attacks the acetylcholine receptors at the neuromuscular junction
• Antibodies block or destroy acetylcholine receptors, leading to muscle weakness
• Thymus gland abnormalities may contribute to the development of myasthenia gravis
• Genetic predisposition and environmental triggers may also play a role in the development of the disease

Symptoms of Myasthenia Gravis

• Muscle weakness that worsens with activity and improves with rest, especially in muscles that control eye movement, swallowing, and breathing
• Drooping eyelids (ptosis) and double vision (diplopia) due to weakened eye muscles
• Difficulty speaking, swallowing, or breathing due to weakened muscles in the face, throat, and lungs
• Weakness in arms and legs, making everyday activities like walking or climbing stairs challenging
• Drooping head or neck due to weakened neck muscles
• Difficulty holding up the head due to weakened neck and shoulder muscles

Diagnostic Tests for Myasthenia Gravis

• Medical history and physical examination to assess muscle weakness and other symptoms
• Blood tests to detect acetylcholine receptor and muscle-specific kinase (MuSK) antibodies
• Electromyography (EMG) to measure muscle activity and detect neuromuscular transmission defects
• Repetitive nerve stimulation test to assess muscle fatigue and weakness
• Imaging tests (e.g., CT or MRI) to rule out other conditions with similar symptoms
• Edrophonium test (Tensilon test) to diagnose myasthenia gravis by temporarily improving muscle strength

Treatment Options for Myasthenia Gravis

• Medications:
  • Acetylcholinesterase inhibitors (e.g., pyridostigmine) to increase muscle strength
  • Immunosuppressive medications (e.g., prednisone, azathioprine) to reduce antibody production
  • Monoclonal antibodies (e.g., eculizumab) to reduce antibody production
• Plasmapheresis to remove antibodies from the blood, reducing symptoms
• Intravenous immunoglobulin (IVIG) to reduce antibody production and improve symptoms
• Thymectomy (surgical removal of the thymus gland) for some patients to reduce antibody production
• Respiratory support with mechanical ventilation if necessary, especially in severe cases

Lifestyle Management for Myasthenia Gravis

• Rest and avoid fatigue to manage muscle weakness
• Take regular breaks to rest muscles and reduce fatigue
• Avoid stress and anxiety to reduce symptoms
• Maintain a healthy diet and stay hydrated to improve overall health
• Exercise regularly, but avoid overexertion to prevent muscle fatigue
• Get enough sleep and practice good sleep hygiene to reduce fatigue
• Avoid extreme temperatures and humidity to reduce symptoms

Pathophysiology of Myasthenia Gravis

• Autoimmune disorder where the immune system attacks the acetylcholine receptors at the neuromuscular junction
• Antibodies block or destroy acetylcholine receptors, leading to muscle weakness and fatigue
• Thymus gland abnormalities may contribute to the development of myasthenia gravis
• Genetic predisposition and environmental triggers may also play a role in the development of the disease