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The use of medicinal products is permitted only upon a doctor’s prescription. Consultations are provided by clinic specialists in person or online in accordance with applicable law.
CHECKUP OF MYASTHENIA
Comprehensive Check-up "Myasthenia" enables the detection of autoimmune mechanisms of the disease, assessment of comorbid disorders, and differential diagnosis with other neuromuscular diseases. An expanded testing profile and neurologist consultation ensure the most accurate diagnosis and help initiate timely treatment.
1. Laboratory Diagnostics (Specific Antibodies)
This is the key step to confirm the diagnosis and determine the form of myasthenia.
- Antibodies to Acetylcholine Receptors (AChR Abs):
Purpose: The main marker, found in 80–85% of patients with the generalized form and 50% with the ocular form.
- Antibodies to Muscle-specific Tyrosine Kinase (MuSK Abs):
Purpose: Tested if AChR test is negative (seronegative myasthenia). Present in 40% of AChR-negative patients, often associated with more severe course and involvement of bulbar muscles.
- Antibodies to Lipoprotein-related Protein 4 (LRP4):
Purpose: An additional marker for double seronegative patients (when both AChR and MuSK are negative).
- Antibodies to Titin (Anti-titin) and Ryanodine Receptors (RyR):
Purpose: Markers of severe disease and strong predictors of thymoma presence (tumor of the thymus), especially in patients under 60 years old.
2. Instrumental and Functional Diagnostics
- Electroneuromyography (ENMG) with Decrement Test (Rhythmic Stimulation):
Purpose: To assess the reliability of neuromuscular transmission. A specific drop (decrement) in M-response amplitude of more than 10% during repeated low-frequency stimulation (2–3 Hz) is sought.
- Single-Fiber Electromyography (SFEMG):
Purpose: The most sensitive method (up to 95–99%). Measures "jitter" (variability in impulse transmission timing). Used if standard ENMG is normal but clinical symptoms persist.
- CT or MRI of the Anterior Mediastinal Organs (with contrast):
Purpose: Mandatory screening for thymic hyperplasia or thymoma. Thymus pathology is directly related to the autoimmune process in myasthenia.
3. General Clinical and Autoimmune Profile (Differential Diagnosis)
Myasthenia is often associated with other autoimmune diseases, and some somatic disorders may exacerbate weakness.
- Thyroid Panel: TSH, Free T3, Free T4, antibodies to thyroid peroxidase (anti-TPO) and thyroglobulin (anti-TG). Thyroid disorders (Hashimoto's, Graves' disease) are comorbid with myasthenia.
- Complete Blood Count + ESR, C-Reactive Protein (CRP): To exclude hidden inflammatory processes.
- Blood Electrolytes: Potassium (K⁺), Calcium (Ca²⁺), Magnesium (Mg²⁺), Sodium (Na⁺). Electrolyte imbalances may mimic or worsen muscle weakness.
4. Respiratory Function Assessment (Critical in Generalized Cases)
- Spirometry (Pulmonary Function Test - PFT):
Purpose: To evaluate lung vital capacity (VC) and forced vital capacity (FVC). Conducted to monitor the risk of myasthenic crisis and respiratory muscle involvement.
1. Laboratory Diagnostics (Specific Antibodies)
This is the key step to confirm the diagnosis and determine the form of myasthenia.
- Antibodies to Acetylcholine Receptors (AChR Abs):
Purpose: The main marker, found in 80–85% of patients with the generalized form and 50% with the ocular form.
- Antibodies to Muscle-specific Tyrosine Kinase (MuSK Abs):
Purpose: Tested if AChR test is negative (seronegative myasthenia). Present in 40% of AChR-negative patients, often associated with more severe course and involvement of bulbar muscles.
- Antibodies to Lipoprotein-related Protein 4 (LRP4):
Purpose: An additional marker for double seronegative patients (when both AChR and MuSK are negative).
- Antibodies to Titin (Anti-titin) and Ryanodine Receptors (RyR):
Purpose: Markers of severe disease and strong predictors of thymoma presence (tumor of the thymus), especially in patients under 60 years old.
2. Instrumental and Functional Diagnostics
- Electroneuromyography (ENMG) with Decrement Test (Rhythmic Stimulation):
Purpose: To assess the reliability of neuromuscular transmission. A specific drop (decrement) in M-response amplitude of more than 10% during repeated low-frequency stimulation (2–3 Hz) is sought.
- Single-Fiber Electromyography (SFEMG):
Purpose: The most sensitive method (up to 95–99%). Measures "jitter" (variability in impulse transmission timing). Used if standard ENMG is normal but clinical symptoms persist.
- CT or MRI of the Anterior Mediastinal Organs (with contrast):
Purpose: Mandatory screening for thymic hyperplasia or thymoma. Thymus pathology is directly related to the autoimmune process in myasthenia.
3. General Clinical and Autoimmune Profile (Differential Diagnosis)
Myasthenia is often associated with other autoimmune diseases, and some somatic disorders may exacerbate weakness.
- Thyroid Panel: TSH, Free T3, Free T4, antibodies to thyroid peroxidase (anti-TPO) and thyroglobulin (anti-TG). Thyroid disorders (Hashimoto's, Graves' disease) are comorbid with myasthenia.
- Complete Blood Count + ESR, C-Reactive Protein (CRP): To exclude hidden inflammatory processes.
- Blood Electrolytes: Potassium (K⁺), Calcium (Ca²⁺), Magnesium (Mg²⁺), Sodium (Na⁺). Electrolyte imbalances may mimic or worsen muscle weakness.
4. Respiratory Function Assessment (Critical in Generalized Cases)
- Spirometry (Pulmonary Function Test - PFT):
Purpose: To evaluate lung vital capacity (VC) and forced vital capacity (FVC). Conducted to monitor the risk of myasthenic crisis and respiratory muscle involvement.
1000у.е.
WHAT IS INCLUDED IN THIS CHECK-UP:
Laboratory tests
Specific laboratory profile:
- IgG antibodies to acetylcholine receptors (AChR).
- Antibodies to muscle-specific tyrosine kinase (MuSK).
- Antibodies to LRP4 protein (lipoprotein-related receptor protein 4) (Rödger Laboratory, Germany).
- Antibodies to titin (connectin) (Rödger Laboratory, Germany).
- Antibodies to ryanodine receptor (RyR1-Ak) (Rödger Laboratory, Germany).
- Ganglioside profile, IgG/IgM antibodies (GM1, GM2, GM3, GM4, GD1a, GD1b, GD2, GD3, GT1a, GT1b, GQ1b), immunoblot.
- Creatine kinase-MM (CK-MM).
- Lactate dehydrogenase (LDH).
General tests and related markers:
- Thyroid hormones and antibodies:
- TSH;
- Free T4;
- Free T3;
- Antibodies to thyroglobulin (Anti-TG);
- Antibodies to thyroid peroxidase (Anti-TPO).
- Electrolytes (sodium, potassium, chloride, calcium) and magnesium.
- Complete blood count.
- C-reactive protein (CRP).
- Vitamin B12 (cyanocobalamin).
- Serum iron.
- Ferritin.
Neurologist consultation.
Medical support by a coordinator at all stages of the examination.
--------------------------------------
For this check-up in myasthenia, no special complex preparation is required; however, following several guidelines will help obtain the most accurate results.
Preparation for examination:
- Blood must be drawn in the morning on an empty stomach (after 8–12 hours of fasting). Only non-carbonated water is allowed.
- Avoid alcohol 24 hours before the examination.
- Avoid intense physical activity, sports, and sauna visits for 24 hours before testing.
- Refrain from smoking, drinking coffee, strong tea, or energy drinks 1–2 hours before blood sampling.
- It is advisable to remain in a calm state for 15–20 minutes before the analysis in the morning.
Medication intake:
- Do not stop taking prescribed medications on your own.
- If you are taking medications for myasthenia treatment (pyridostigmine, kalimin, proserin), immunosuppressants, hormonal drugs, or any other medications, be sure to inform your doctor and laboratory staff.
- Temporary discontinuation of any medication before certain tests is determined only by the attending physician.
Additional recommendations:
- It is preferable to take tests before infusion therapy, intravenous injections, and physiotherapy procedures.
- If a neurologist consultation is planned simultaneously, bring all existing medical documents: previous test results, electromyography (EMG) results, CT, MRI scans, hospital discharge summaries, and a list of medications taken.
This approach will allow the doctor to more accurately assess disease activity, confirm or exclude the autoimmune nature of myasthenia, and select the optimal treatment strategy.
Laboratory tests
Specific laboratory profile:
- IgG antibodies to acetylcholine receptors (AChR).
- Antibodies to muscle-specific tyrosine kinase (MuSK).
- Antibodies to LRP4 protein (lipoprotein-related receptor protein 4) (Rödger Laboratory, Germany).
- Antibodies to titin (connectin) (Rödger Laboratory, Germany).
- Antibodies to ryanodine receptor (RyR1-Ak) (Rödger Laboratory, Germany).
- Ganglioside profile, IgG/IgM antibodies (GM1, GM2, GM3, GM4, GD1a, GD1b, GD2, GD3, GT1a, GT1b, GQ1b), immunoblot.
- Creatine kinase-MM (CK-MM).
- Lactate dehydrogenase (LDH).
General tests and related markers:
- Thyroid hormones and antibodies:
- TSH;
- Free T4;
- Free T3;
- Antibodies to thyroglobulin (Anti-TG);
- Antibodies to thyroid peroxidase (Anti-TPO).
- Electrolytes (sodium, potassium, chloride, calcium) and magnesium.
- Complete blood count.
- C-reactive protein (CRP).
- Vitamin B12 (cyanocobalamin).
- Serum iron.
- Ferritin.
Neurologist consultation.
Medical support by a coordinator at all stages of the examination.
--------------------------------------
For this check-up in myasthenia, no special complex preparation is required; however, following several guidelines will help obtain the most accurate results.
Preparation for examination:
- Blood must be drawn in the morning on an empty stomach (after 8–12 hours of fasting). Only non-carbonated water is allowed.
- Avoid alcohol 24 hours before the examination.
- Avoid intense physical activity, sports, and sauna visits for 24 hours before testing.
- Refrain from smoking, drinking coffee, strong tea, or energy drinks 1–2 hours before blood sampling.
- It is advisable to remain in a calm state for 15–20 minutes before the analysis in the morning.
Medication intake:
- Do not stop taking prescribed medications on your own.
- If you are taking medications for myasthenia treatment (pyridostigmine, kalimin, proserin), immunosuppressants, hormonal drugs, or any other medications, be sure to inform your doctor and laboratory staff.
- Temporary discontinuation of any medication before certain tests is determined only by the attending physician.
Additional recommendations:
- It is preferable to take tests before infusion therapy, intravenous injections, and physiotherapy procedures.
- If a neurologist consultation is planned simultaneously, bring all existing medical documents: previous test results, electromyography (EMG) results, CT, MRI scans, hospital discharge summaries, and a list of medications taken.
This approach will allow the doctor to more accurately assess disease activity, confirm or exclude the autoimmune nature of myasthenia, and select the optimal treatment strategy.
