Airway limitation and exercise intolerance in well-regulated myasthenia gravis patients
A. Elsais
Department of Neurology, Oslo University Hospital, Oslo, Norway
University of Oslo, Oslo, Norway
Search for more papers by this authorB. Johansen
University of Oslo, Oslo, Norway
Department of Respiratory Medicine, Division of Cardiovascular and Respiratory Medicine, Oslo University Hospital, Oslo, Norway
Search for more papers by this authorE. Kerty
Department of Neurology, Oslo University Hospital, Oslo, Norway
University of Oslo, Oslo, Norway
Search for more papers by this authorA. Elsais
Department of Neurology, Oslo University Hospital, Oslo, Norway
University of Oslo, Oslo, Norway
Search for more papers by this authorB. Johansen
University of Oslo, Oslo, Norway
Department of Respiratory Medicine, Division of Cardiovascular and Respiratory Medicine, Oslo University Hospital, Oslo, Norway
Search for more papers by this authorE. Kerty
Department of Neurology, Oslo University Hospital, Oslo, Norway
University of Oslo, Oslo, Norway
Search for more papers by this authorConflicts of interest: none.
Abstract
Elsais A, Johansen B, Kerty E. Airway limitation and exercise intolerance in well-regulated myasthenia gravis patients. Acta Neurol Scand: 2010: 122 (Suppl. 190): 12–17. © 2010 John Wiley & Sons A/S.
Objectives – Myasthenia gravis (MG) is an autoimmune disease of neuromuscular synapses, characterized by muscular weakness and reduced endurance. Remission can be obtained in many patients. However, some of these patients complain of fatigue. The aim of this study was to assess exercise capacity and lung function in well-regulated MG patients.
Patients and methods – Ten otherwise healthy MG patients and 10 matched controls underwent dynamic spirometry, and a ramped symptom-limited bicycle exercise test. Spirometric variables included forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and maximum voluntary ventilation (MVV). Exercise variables included maximal oxygen uptake (VO2 max), anaerobic threshold (VO2 AT) maximum work load (W), maximum ventilation (VE max), and limiting symptom.
Results – Myasthenia gravis patients had significantly lower FEV1/FVC ratio than controls. This was more marked in patients on acetylcholine esterase inhibitors. On the contrary, patients not using acetylcholine esterase inhibitors had a significantly lower exercise endurance time.
Conclusion – Well-regulated MG patients, especially those using pyridostigmine, tend to have an airway obstruction. The modest airway limitation might be a contributing factor to their fatigue. Patients who are not using acetylcholinesterase inhibitor seem to have diminished exercise endurance in spite of their clinically complete remission.
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