{"id":352,"date":"2022-10-24T19:02:01","date_gmt":"2022-10-24T19:02:01","guid":{"rendered":"https:\/\/centrodemiastenia.com\/medicos\/?page_id=352"},"modified":"2022-11-16T19:29:14","modified_gmt":"2022-11-16T19:29:14","slug":"clasificacion-de-la-miastenia","status":"publish","type":"page","link":"https:\/\/centrodemiastenia.com\/medicos\/clasificacion-de-la-miastenia\/","title":{"rendered":"Clasificaci\u00f3n de la miastenia"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"352\" class=\"elementor elementor-352\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6e2acda8 elementor-section-height-min-height elementor-hidden-desktop elementor-hidden-tablet elementor-section-boxed elementor-section-height-default elementor-section-items-middle\" data-id=\"6e2acda8\" data-element_type=\"section\" id=\"miastenia\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-13ac841c\" data-id=\"13ac841c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3980d98c elementor-widget elementor-widget-image\" data-id=\"3980d98c\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.8.1 - 13-11-2022 *\/\n.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=\".svg\"]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block}<\/style>\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"1770\" height=\"314\" src=\"https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Component-1-\u2013-1-e1666120104666.png\" class=\"attachment-full size-full\" alt=\"\" loading=\"lazy\" srcset=\"https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Component-1-\u2013-1-e1666120104666.png 1770w, https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Component-1-\u2013-1-e1666120104666-300x53.png 300w, https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Component-1-\u2013-1-e1666120104666-1024x182.png 1024w, https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Component-1-\u2013-1-e1666120104666-768x136.png 768w, https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Component-1-\u2013-1-e1666120104666-1536x272.png 1536w\" sizes=\"(max-width: 1770px) 100vw, 1770px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-27b7cc72 elementor-section-height-min-height elementor-section-items-bottom elementor-hidden-mobile elementor-section-boxed elementor-section-height-default\" data-id=\"27b7cc72\" data-element_type=\"section\" id=\"miastenia\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-9d8a533\" data-id=\"9d8a533\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1f3affe5 elementor-widget elementor-widget-image\" data-id=\"1f3affe5\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"1770\" height=\"314\" src=\"https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Component-1-\u2013-1-e1666120104666.png\" class=\"attachment-full size-full\" alt=\"\" loading=\"lazy\" srcset=\"https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Component-1-\u2013-1-e1666120104666.png 1770w, https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Component-1-\u2013-1-e1666120104666-300x53.png 300w, https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Component-1-\u2013-1-e1666120104666-1024x182.png 1024w, https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Component-1-\u2013-1-e1666120104666-768x136.png 768w, https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Component-1-\u2013-1-e1666120104666-1536x272.png 1536w\" sizes=\"(max-width: 1770px) 100vw, 1770px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-348588c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"348588c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7da64c4\" data-id=\"7da64c4\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-cd4cf50 elementor-widget elementor-widget-heading\" data-id=\"cd4cf50\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.8.1 - 13-11-2022 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h2 class=\"elementor-heading-title elementor-size-default\">CLASIFICACI\u00d3N DE LA MIASTENIA<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-c43f5cb elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c43f5cb\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-075ff4e\" data-id=\"075ff4e\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-416d268 elementor-widget elementor-widget-text-editor\" data-id=\"416d268\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.8.1 - 13-11-2022 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#818a91;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#818a91;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<p>Seg\u00fan la edad de inicio de los s\u00edntomas, la MG puede ser:<br \/>\u2022 <b>De inicio temprano<\/b>: antes de los 50 a\u00f1os, frecuentemente con hiperplasia t\u00edmica asociada y buena respuesta a la timectom\u00eda.<sup>4,5<\/sup><br \/>\u2022 <b>De inicio tard\u00edo<\/b>: despu\u00e9s de los 50 a\u00f1os, con atrofia t\u00edmica y utilidad discutible de la timectom\u00eda.4 Es m\u00e1s frecuente en los varones, y se asocia con alta frecuencia de AChRA y Ac anti titina.<sup>6<\/sup><br \/>Los avances en las pruebas de laboratorio han contribuido a la caracterizaci\u00f3n fenot\u00edpica, que a\u00fan se encuentra en evoluci\u00f3n. Estas formas difieren en base al tipo de autoanticuerpos detectables y la fisiopatolog\u00eda, los s\u00edntomas predominantes y la respuesta al tratamiento, lo cual tiene implicancias en la toma de decisiones:<sup>1,3<\/sup><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-7afdb9f\" data-id=\"7afdb9f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1569c1b elementor-widget elementor-widget-image\" data-id=\"1569c1b\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"402\" height=\"402\" src=\"https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Imagen.png\" class=\"attachment-large size-large\" alt=\"\" loading=\"lazy\" srcset=\"https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Imagen.png 402w, https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Imagen-300x300.png 300w, https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Imagen-150x150.png 150w\" sizes=\"(max-width: 402px) 100vw, 402px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2f426e93 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2f426e93\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-25390417\" data-id=\"25390417\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2047ca01 elementor-widget elementor-widget-eael-adv-tabs\" data-id=\"2047ca01\" data-element_type=\"widget\" id=\"tab-tab\" data-widget_type=\"eael-adv-tabs.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t        <div id=\"eael-advance-tabs-2047ca01\" class=\"eael-advance-tabs eael-tabs-horizontal eael-tab-auto-active active-caret-on responsive-vertical-layout\" data-tabid=\"2047ca01\">\n            <div class=\"eael-tabs-nav\">\n                <ul class=\"\">\n                                            <li id=\"bfenotipob-brmg-achra-brpositivasup-stylefont-size-13px147sup\" class=\"inactive eael-tab-item-trigger\" aria-selected=\"true\" data-tab=\"1\" role=\"tab\" tabindex=\"0\" aria-controls=\"bfenotipob-brmg-achra-brpositivasup-stylefont-size-13px147sup-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title  title-after-icon\"><b>FENOTIPO:<\/b> <br>MG ACHRA <br>POSITIVA<sup style=\"font-size: 13px\">1,4,7<\/sup><\/span>                                                    <\/li>\n                                            <li id=\"bfenotipob-brmg-con-acbranti-musksup-stylefont-size-13px146-10sup\" class=\"inactive eael-tab-item-trigger\" aria-selected=\"false\" data-tab=\"2\" role=\"tab\" tabindex=\"-1\" aria-controls=\"bfenotipob-brmg-con-acbranti-musksup-stylefont-size-13px146-10sup-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title  title-after-icon\"><b>FENOTIPO:<\/b> <br>MG CON AC<br>ANTI MUSK<sup style=\"font-size: 13px\">1,4,6-10<\/sup><\/span>                                                    <\/li>\n                                            <li id=\"bfenotipob-brmg-doblebrseropositiva\" class=\"inactive eael-tab-item-trigger\" aria-selected=\"false\" data-tab=\"3\" role=\"tab\" tabindex=\"-1\" aria-controls=\"bfenotipob-brmg-doblebrseropositiva-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title  title-after-icon\"><b>FENOTIPO:<\/b> <br>MG DOBLE<br>SEROPOSITIVA<\/span>                                                    <\/li>\n                                            <li id=\"bmgb-brseronegativabranti-lrp-4sup-stylefont-size-13px7sup\" class=\"inactive eael-tab-item-trigger\" aria-selected=\"false\" data-tab=\"4\" role=\"tab\" tabindex=\"-1\" aria-controls=\"bmgb-brseronegativabranti-lrp-4sup-stylefont-size-13px7sup-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title  title-after-icon\"><b>MG:<\/b> <br>SERONEGATIVA<br>ANTI LRP-4<sup style=\"font-size: 13px\">7<\/sup><\/span>                                                    <\/li>\n                                            <li id=\"bfenotipob-brmgbrseronegativa\" class=\"inactive eael-tab-item-trigger\" aria-selected=\"false\" data-tab=\"5\" role=\"tab\" tabindex=\"-1\" aria-controls=\"bfenotipob-brmgbrseronegativa-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title  title-after-icon\"><b>FENOTIPO:<\/b> <br>MG<br>SERONEGATIVA<\/span>                                                    <\/li>\n                                            <li id=\"bfenotipob-brmg-ocularsup-stylefont-size-13px16supbrspan-stylecolor-dfdfdf-span\" class=\"inactive eael-tab-item-trigger\" aria-selected=\"false\" data-tab=\"6\" role=\"tab\" tabindex=\"-1\" aria-controls=\"bfenotipob-brmg-ocularsup-stylefont-size-13px16supbrspan-stylecolor-dfdfdf-span-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title  title-after-icon\"><b>FENOTIPO:<\/b> <br>MG OCULAR<sup style=\"font-size: 13px\">1,6<\/sup><br><span style=\"color: #dfdfdf\">.<\/span><\/span>                                                    <\/li>\n                                    <\/ul>\n            <\/div>\n            \n            <div class=\"eael-tabs-content\">\n\t\t        \n                    <div id=\"bfenotipob-brmg-achra-brpositivasup-stylefont-size-13px147sup-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"bfenotipob-brmg-achra-brpositivasup-stylefont-size-13px147sup-tab\">\n\t\t\t\t        \t\t\t\t\t        \t\t<div data-elementor-type=\"section\" data-elementor-id=\"865\" class=\"elementor elementor-865\">\n\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-101822e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"101822e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-c12e7f6\" data-id=\"c12e7f6\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7550d7f elementor-widget elementor-widget-heading\" data-id=\"7550d7f\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">PRINCIPALES CARACTER\u00cdSTICAS CONOCIDAS\n<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-26aad30 elementor-widget elementor-widget-text-editor\" data-id=\"26aad30\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>\u2022 Presentaci\u00f3n bimodal. <br \/>\u2022 Con inicio de s\u00edntomas oculares, que suelen generalizarse entre el primer y segundo a\u00f1os. <br \/>\u2022 Progresi\u00f3n de la enfermedad no uniforme; 10-15% presentan remisi\u00f3n espont\u00e1nea. <br \/>\u2022 Los Ac son de tipo IgG1 e IgG3, capaces de activar el complemento y formar complejos de ataque a membrana (MAC, en ingl\u00e9s), que degradan al receptor de acetilcolina. <br \/>\u2022 Hay da\u00f1o degenerativo de la uni\u00f3n neuromuscular. Los AChRA tambi\u00e9n causan bloqueo funcional de la transmisi\u00f3n mediada por acetilcolina (ACh).<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-922f886\" data-id=\"922f886\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9b11ccc elementor-widget elementor-widget-heading\" data-id=\"9b11ccc\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Uni\u00f3n neuromuscular<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1dfb771 elementor-widget elementor-widget-image\" data-id=\"1dfb771\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"572\" height=\"482\" src=\"https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Ilustracion-1.png\" class=\"attachment-full size-full\" alt=\"\" loading=\"lazy\" srcset=\"https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Ilustracion-1.png 572w, https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Ilustracion-1-300x253.png 300w\" sizes=\"(max-width: 572px) 100vw, 572px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-71c28c4 elementor-widget elementor-widget-text-editor\" data-id=\"71c28c4\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\tMecanismos inmunopatol\u00f3gicos mediados por IgG1 en la MG.<br>\nEn recuadros, estrategias terap\u00e9uticas potencialmente eficaces.\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t                            <\/div>\n\t\t        \n                    <div id=\"bfenotipob-brmg-con-acbranti-musksup-stylefont-size-13px146-10sup-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"bfenotipob-brmg-con-acbranti-musksup-stylefont-size-13px146-10sup-tab\">\n\t\t\t\t        \t\t\t\t\t        \t\t<div data-elementor-type=\"section\" data-elementor-id=\"873\" class=\"elementor elementor-873\">\n\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-101822e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"101822e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-c12e7f6\" data-id=\"c12e7f6\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7550d7f elementor-widget elementor-widget-heading\" data-id=\"7550d7f\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">PRINCIPALES CARACTER\u00cdSTICAS CONOCIDAS\n<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-26aad30 elementor-widget elementor-widget-text-editor\" data-id=\"26aad30\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>\u2022 M\u00e1s frecuente en mujeres j\u00f3venes. <br \/>\u2022 Afecta predominantemente m\u00fasculos bulbares, faciales y del cuello. <br \/>\u2022 Las crisis miast\u00e9nicas son m\u00e1s frecuentes. <br \/>\u2022 Los Ac son de tipo IgG4, no asociados a complemento (hay m\u00ednimos cambios destructivos en la uni\u00f3n neuromuscular).<br \/>\u2022 Los Ac se unen al complejo agrina-LRP-4-MuSK, cuya principal funci\u00f3n es la diferenciaci\u00f3n y el mantenimiento de la uni\u00f3n neuromuscular incluidas la distribuci\u00f3n y agrupamiento de los receptores de acetilcolina. Al unirse al complejo, se reduce el n\u00famero de receptores de acetilcolina disponibles, causando bloqueo funcional.<br \/>\u2022 Los pacientes tienen menos probabilidad de tener alteraciones t\u00edmicas y prueba de estimulaci\u00f3n repetitiva positiva.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-922f886\" data-id=\"922f886\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9b11ccc elementor-widget elementor-widget-heading\" data-id=\"9b11ccc\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Uni\u00f3n neuromuscular<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1dfb771 elementor-widget elementor-widget-image\" data-id=\"1dfb771\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"587\" height=\"518\" src=\"https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Ilustacion.png\" class=\"attachment-full size-full\" alt=\"\" loading=\"lazy\" srcset=\"https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Ilustacion.png 587w, https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Ilustacion-300x265.png 300w\" sizes=\"(max-width: 587px) 100vw, 587px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-71c28c4 elementor-widget elementor-widget-text-editor\" data-id=\"71c28c4\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Mecanismos inmunopatol\u00f3gicos mediados por IgG4 en la MG. En recuadros, estrategias terap\u00e9uticas potencialmente eficaces .<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-d3f8884 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"d3f8884\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-91a553f\" data-id=\"91a553f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-bba9422 elementor-widget elementor-widget-text-editor\" data-id=\"bba9422\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>\u2022 La respuesta a los anticolinester\u00e1sicos suele ser inadecuada y se requieren inmunosupresores (buena respuesta a corticoesteroides en altas dosis, azatioprina o rituximab).<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t                            <\/div>\n\t\t        \n                    <div id=\"bfenotipob-brmg-doblebrseropositiva-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"bfenotipob-brmg-doblebrseropositiva-tab\">\n\t\t\t\t        \t\t\t\t\t        <p><strong><span style=\"color: #61831e;\">PRINCIPALES CARACTER\u00cdSTICAS CONOCIDAS<\/span><\/strong><\/p><p>\u2022 No est\u00e1 aun completamente caracterizada.<br \/>\u2022 Presenta AChRA y Ac anti MuSK positivos.<br \/>\u2022 Fenotipo similar a la MG con Ac anti MuSK positiva.<\/p>\t\t\t\t                            <\/div>\n\t\t        \n                    <div id=\"bmgb-brseronegativabranti-lrp-4sup-stylefont-size-13px7sup-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"bmgb-brseronegativabranti-lrp-4sup-stylefont-size-13px7sup-tab\">\n\t\t\t\t        \t\t\t\t\t        <p><strong><span style=\"color: #61831e;\">PRINCIPALES CARACTER\u00cdSTICAS CONOCIDAS<\/span><\/strong><\/p><p>\u2022 Ac principalmente del tipo IgG1, activadores de complemento.<br \/>\u2022 Alteran la se\u00f1alizaci\u00f3n agrina-LRP-4, con lo cual se afecta la activaci\u00f3n de MuSK.<\/p>\t\t\t\t                            <\/div>\n\t\t        \n                    <div id=\"bfenotipob-brmgbrseronegativa-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"bfenotipob-brmgbrseronegativa-tab\">\n\t\t\t\t        \t\t\t\t\t        <p><strong><span style=\"color: #61831e;\">PRINCIPALES CARACTER\u00cdSTICAS CONOCIDAS<br \/><\/span><\/strong><\/p><p>\u2022 Ning\u00fan autoanticuerpo detectable con capacidad patog\u00e9nica demostrada.<\/p>\t\t\t\t                            <\/div>\n\t\t        \n                    <div id=\"bfenotipob-brmg-ocularsup-stylefont-size-13px16supbrspan-stylecolor-dfdfdf-span-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"bfenotipob-brmg-ocularsup-stylefont-size-13px16supbrspan-stylecolor-dfdfdf-span-tab\">\n\t\t\t\t        \t\t\t\t\t        <p><strong><span style=\"color: #61831e;\">PRINCIPALES CARACTER\u00cdSTICAS CONOCIDAS<\/span><\/strong><\/p><p>\u2022 En 15% a 20% de los pacientes, los s\u00edntomas contin\u00faan siendo solo oculares, luego de m\u00e1s de 2 a\u00f1os desde el inicio.<br \/>\u2022 Es m\u00e1s frecuente en varones, con comienzo a mayor edad.<br \/>\u2022 Los corticoesteroides en dosis baja suelen ser eficaces.<\/p>\t\t\t\t                            <\/div>\n\t\t                    <\/div>\n        <\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e58061e elementor-widget elementor-widget-text-editor\" data-id=\"e58061e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>La <em>Myasthenia Gravis Foundation of America<\/em> (MGFA) divide a la MG en cinco clases principales (I a V) seg\u00fan los rasgos cl\u00ednicos y la severidad, lo que implica valor pron\u00f3stico.<sup>4<\/sup><br \/>\u2022 Desde Clase I con debilidad muscular extraocular solamente, hasta Clase V, que requiere intubaci\u00f3n.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-43797fec elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"43797fec\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7a96613c\" data-id=\"7a96613c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3d27483b elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"3d27483b\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.8.1 - 13-11-2022 *\/\n.elementor-widget-divider{--divider-border-style:none;--divider-border-width:1px;--divider-color:#2c2c2c;--divider-icon-size:20px;--divider-element-spacing:10px;--divider-pattern-height:24px;--divider-pattern-size:20px;--divider-pattern-url:none;--divider-pattern-repeat:repeat-x}.elementor-widget-divider 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.elementor-divider__element{margin-right:0}.elementor-widget-divider:not(.elementor-widget-divider--view-line_text):not(.elementor-widget-divider--view-line_icon) .elementor-divider-separator{border-top:var(--divider-border-width) var(--divider-border-style) var(--divider-color)}.elementor-widget-divider--separator-type-pattern{--divider-border-style:none}.elementor-widget-divider--separator-type-pattern.elementor-widget-divider--view-line .elementor-divider-separator,.elementor-widget-divider--separator-type-pattern:not(.elementor-widget-divider--view-line) .elementor-divider-separator:after,.elementor-widget-divider--separator-type-pattern:not(.elementor-widget-divider--view-line) .elementor-divider-separator:before,.elementor-widget-divider--separator-type-pattern:not([class*=elementor-widget-divider--view]) .elementor-divider-separator{width:100%;min-height:var(--divider-pattern-height);-webkit-mask-size:var(--divider-pattern-size) 100%;mask-size:var(--divider-pattern-size) 100%;-webkit-mask-repeat:var(--divider-pattern-repeat);mask-repeat:var(--divider-pattern-repeat);background-color:var(--divider-color);-webkit-mask-image:var(--divider-pattern-url);mask-image:var(--divider-pattern-url)}.elementor-widget-divider--no-spacing{--divider-pattern-size:auto}.elementor-widget-divider--bg-round{--divider-pattern-repeat:round}.rtl .elementor-widget-divider .elementor-divider__text{direction:rtl}.e-con-inner>.elementor-widget-divider,.e-con>.elementor-widget-divider{width:var(--container-widget-width,100%)}<\/style>\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d2e330d elementor-widget elementor-widget-text-editor\" data-id=\"d2e330d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><strong>Referencias: 1.<\/strong> . Pascuzzi R, Bodkin CL. Chapter 53. Disorders of the neuromuscular junction. En: Jos\u00e9 Biller. Practical Neurology Fifth edition. Philadelphia: Wolters Kluwer; 2017. p. 685-696. <strong>2.<\/strong> Hoch W, McConville J, Helms S, et al. Auto-antibodies to the receptor tyrosine kinase MuSK in patients with myasthenia gravis without acetylcholine receptor antibodies. Nature Medicine 2001;7(3):365-8. <strong>3.<\/strong> Bubuiok AM, Kudebayeva A, Turuspekova S, et al. The epidemiology of myasthenia gravis. J Med Life 2021;14:7-16.<strong> 4.<\/strong> Beloor Suresh A, Asuncion RMD. Myasthenia Gravis. [Actualizado en agosto de 2021]. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. En: <span style=\"color: #00ccff;\"><a style=\"color: #5b82f0;\" href=\"https:\/\/www.statpearls.com\/ArticleLibrary\/viewarticle\/25411\" target=\"blank_\">https:\/\/www.statpearls.com\/ArticleLibrary\/viewarticle\/25411<\/a><\/span> <strong>5.<\/strong> Wolfe GI, Kaminski HJ, Aban IB, et al. Randomized trial of thymectomy in myasthenia gravis. N Engl J Med. 2016;375(6):511-22. <strong>6.<\/strong> Deymeer F. Myasthenia gravis: MuSK MG, late-onset MG and ocular MG. Acta Myologica. 2020; 39(4):345-52.<strong> 7.<\/strong> Fichtner ML, Jiang R, Bourke A, et al. Autoimmune pathology in myasthenia gravis disease subtypes is governed by divergent mechanisms of immunopathology. Front Immunol. 2020;11:776. <strong>8.<\/strong> Borges LS, Richman DP. Muscle-specific kinase myasthenia gravis. Front Immunol. 2020;11:707. <strong>9.<\/strong> Burden SJ, Yumoto N, Zhang W. The Role of MuSK in Synapse Formation and Neuromuscular Disease. Cold Spring Harb Perspect Biol. 2013;5:a009167. <strong>10.<\/strong> Koneczny I, Stevens J, De Rosa A, et al. IgG4 autoantibodies against muscle-specific kinase undergo Fab-arm exchange in myasthenia gravis patients. J Autoimmun. 2017;77:104-15.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>CLASIFICACI\u00d3N DE LA MIASTENIA Seg\u00fan la edad de inicio de los s\u00edntomas, la MG puede ser:\u2022 De inicio temprano: antes de los 50 a\u00f1os, frecuentemente con hiperplasia t\u00edmica asociada y buena respuesta a la timectom\u00eda.4,5\u2022 De inicio tard\u00edo: despu\u00e9s de los 50 a\u00f1os, con atrofia t\u00edmica y utilidad discutible de la timectom\u00eda.4 Es m\u00e1s frecuente [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"inline_featured_image":false},"_links":{"self":[{"href":"https:\/\/centrodemiastenia.com\/medicos\/wp-json\/wp\/v2\/pages\/352"}],"collection":[{"href":"https:\/\/centrodemiastenia.com\/medicos\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/centrodemiastenia.com\/medicos\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/centrodemiastenia.com\/medicos\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/centrodemiastenia.com\/medicos\/wp-json\/wp\/v2\/comments?post=352"}],"version-history":[{"count":82,"href":"https:\/\/centrodemiastenia.com\/medicos\/wp-json\/wp\/v2\/pages\/352\/revisions"}],"predecessor-version":[{"id":994,"href":"https:\/\/centrodemiastenia.com\/medicos\/wp-json\/wp\/v2\/pages\/352\/revisions\/994"}],"wp:attachment":[{"href":"https:\/\/centrodemiastenia.com\/medicos\/wp-json\/wp\/v2\/media?parent=352"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}