Morphological and Histochemical Changes in Muscle Biopsies of Myasthenia Gravis with Atypical Clinical Presentation

Hussam Abu Farsakh* and Altaf Ijmail

DOI: 10.26717/BJSTR.2017.01.000115

Received: May 17, 2017   Published: May 31, 2017

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Abstract

We studied the morphological and histochemical changes in muscle biopsies from 6 cases with myasthenia gravis (MG), The patients were misdiagnosed at the initial presentation however they were all proved later by either histochmical and serological tests or improvement on mestinone therapy. Here, we described the changes seen in muscle biopsies of MG with atypical clinical presentation: atrophy of type II fibers; predominance of type I fibers; increased NADH staining at the neuromuscular junction (NMJ). The most consistent finding is marked reduction in acetylcholinesterease (AChE) activity at the end plates in all cases. The results of this study suggest that histochemical and acetylcholinesterase stains, in combination with clinical assessment can help to identify unsuspected cases of MG and can help to target the appropriate clinical investigations.

Keywords: Muscle biopsies; Myasthenia Gravis; Acetyl cholinesterase receptor

Introduction | Patients and Methods | Results | Discussion | Conclusion | References | Figures | Tables |