La Revue du praticien
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Myasthenia gravis is a rare, auto-immune neuromuscular junction disorder. Prevalence rates is about 50/1,000000. The disease results from circulating auto-antibody attacks against post-synaptic targets (acetylcholine receptor [AChR] in 80% cases) on the endplate region of the postsynaptic membrane. ⋯ Myasthenia gravis treatment is based on oral form of cholinesterase inhibitors, corticosteroids and other immunosuppressive drugs in severe forms. During myasthenia crisis, intraveinous immune globulines or plasma exchanges can be used. Thymectomy is proposed in case of thymus abnormality.
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Overwhelming post-splenectomy infection (OPSI) is a long-term risk in asplenic patients, which may be controlled by appropriate preventive measures. Specific guidelines have been developed to reduce its incidence. These guidelines include immunizations, antibioprophylaxis, and education. ⋯ Antibioprophylaxis during 2 to 5 years following splenectomy in children, and 2 years in adults is recommended. Furthermore, long-term education is mandatory. Application of preventing measures is effective and patient's education remains the cornerstone of prevention.