Myasthenia gravis corticosteroids

Engel WK. (1976) Myasthenia gravis, corticosteroids, anticholinesterases. Ann NY Acad Sci 274, 623-630. 

Speciai risk Use with caution in the following situations Nonspecific ulcerative colitis if there is a probability of impending perforation, abscess, or other pyogenic infection diverticulitis fresh intestinal anastomoses hypertension CHF thromboembolitic tendencies thrombophlebitis osteoporosis exanthema Cushing syndrome antibiotic-resistant infections convulsive disorders metastatic carcinoma myasthenia gravis vaccinia varicella diabetes mellitus hypothyroidism, cirrhosis (enhanced effect of corticosteroids). 

Myasthenia gravis is a progressive disorder characterized by muscle weakness eye muscles are often the first affected. Research has shown it to be an autoimmune disease in which the victim forms antibodies to his or her nicotinic acetylcholine receptors at motor endplates. It is characterized by fatigability and weakness of the skeletal muscles, especially those of the eyes. Approximately 90% of the patients have droopy eyelids and double vision. Treatments include corticosteroids and thymectomy to reduce the actions of the immune system and anti-ChE agents such as pyridostigmine to improve the effectiveness of the receptors that remain. 

Anti-inflammatory corticosteroids, for example prednisolone, can be used to suppress the antibody formation in myasthenia gravis. They should be used together with anticholinesterase drugs and once an improvement is seen the dose should be decreased. 

Corticosteroids Anticholinesterases Anticholinesterase effeds may be antagonized in myasthenia gravis. 

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