Myasthenia Gravis in Pregnancy Treated With Daily Massive Vitamin D Dose

Lff, Silva; Mc, Martins; Mc, Caplum; Ms, Luz; Vm, Amaral; Va, de Souza; Hd, de Souza; Alm, Silva; Cr, Panconi; Zimmermmann, Juliana Barroso

doi:10.36502/2020/asjbccr.6208

Cited by 2 publications

(1 citation statement)

References 16 publications

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“…For example, patients with hypercalcemia due to immobilization may also have reduced vitamin D levels (35) while patients with MG may receive plasma exchange, which may deplete serum levels of vitamin D (36). A patient with MG treated with high doses of vitamin D showed a positive prognosis in two previous case reports (37,38). It has been demonstrated Therefore, it is difficult for previous studies to determine whether vitamin D deficiency is a real risk factor or merely a consequence of reduced mobility.…”

Section: Discussionmentioning

confidence: 96%

Causal effect of vitamin D on myasthenia gravis: a two-sample Mendelian randomization study

et al. 2023

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IntroductionObservational studies suggest that vitamin D supplementation may be effective in preventing myasthenia gravis (MG). However, the causal relationship between circulating vitamin D levels and MG remains unclear. This study aimed to examine the genetic causality of circulating vitamin D and MG using data from large population-based genome-wide association studies (GWAS).MethodsSNPs (single nucleotide polymorphisms) strongly associated with exposure were selected. Two-sample Mendelian Randomization (MR) was performed with inverse variance weighting (IVW), MR-Egger (Mendelian randomization-Egger), weight median and MR-PRESSO (Mendelian randomization pleiotropy residual sum and outlier) methods. Heterogeneity was tested via IVW and MR-Egger. Pleiotropy was tested using MR-Egger intercept test and MR-PRESSO method. MR-PRESSO was also used to detect outliers. Leave-one-out analysis was used to identify SNPs with potential effect. Reverse MR analysis was also performed.ResultIn IVW, circulating vitamin D levels had no causal effect on MG [OR = 0.91 (0.67–1.22), p = 0.532] and MG had no causal effect on circulating vitamin D [OR = 1.01 (099–1.02), p = 0.663]. No heterogeneity or pleiotropy was observed (p > 0.05). Other MR methods also agreed with IVW results.ConclusionThis study provides the causal relationship between genetically predicted circulating vitamin D levels and MG and provides new insights into the genetics of MG.

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Section: Discussionmentioning

confidence: 96%

Causal effect of vitamin D on myasthenia gravis: a two-sample Mendelian randomization study

et al. 2023

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Myasthenia Gravis and Vitamin D Serum Levels: A Systematic Review and Meta-analysis

Bonaccorso

2023

CNSNDDT

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Background: Vitamin D has been extensively studied for its role in immune modulation, especially in the process of tolerance induction. The loss of tolerance towards self-antigens is the basis of several autoimmune disorders, this seems to be related to lower levels of Vitamin D. A neurological autoimmune disorder due to the loss of tolerance to compounds at the neuromuscular junction is known as Myasthenia Gravis (MG). Objective: To assess the possible correlation between altered Vitamin D levels and MG. Methods: In this systematic review, all recruited studies compared Vitamin D levels in MG patients and healthy controls. Five studies fulfilled selection criteria and were included for the quantitative synthesis. Methods: The meta-analysis involved data of a total population size of 450 individuals, quite equally divided in 219 cases and 231 controls, respectively. Results: The results showed a statistically significant mean difference between cases and controls. The overall mean Vitamin D levels in MG patients were 4.69 ng/ml lower than control levels (95%CI -6.17; -3.22), by applying a random-effects model this mean difference was estimated at -3.79 (95%CI -7.24; -0.33), after exclusion of data source of heterogeneity and through applying a fixed-effect model, resulted in a mean difference -5.39 (95%CI -6.91; -3.88). The p-value was lower than 0.05. Conclusion: Based on the current data, there are statically significant lower levels of Vitamin D in MG patients, so routine checking and possible correction should be advised in MG patients.

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Myasthenia Gravis in Pregnancy Treated With Daily Massive Vitamin D Dose

Cited by 2 publications

References 16 publications

Causal effect of vitamin D on myasthenia gravis: a two-sample Mendelian randomization study

Causal effect of vitamin D on myasthenia gravis: a two-sample Mendelian randomization study

Myasthenia Gravis and Vitamin D Serum Levels: A Systematic Review and Meta-analysis

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