Interpretation of positive edrophonium (Tensilon) test in patients with end-stage renal disease.
Many patients with end-stage renal disease (ESRD) have signs and symptoms of easy fatigability, fluctuating weakness, apathy, dry mouth, and blurring of vision. These symptoms can be confused with disorders of neuromuscular transmission. When present, the physician may want to determine whether the patient has myasthenia gravis--the commonest of all neuromuscular disorders--and administer the edrophonium (Tensilon) test. An unequivocally positive response to the test must be interpreted with caution in ESRD. However, the exact mechanism of a positive response is unclear but may be explained by metabolic abnormalities related to end-stage renal disease, i.e., uremic toxins, disordered calcium metabolism, abnormal neuromuscular mechanism, associated neurological disorders, or myopathic processes in uremia, all of which can affect neuromuscular transmission.
Khan
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GA
Department of Medicine, Montefiore Medical Center, University Hospital, Albert Einstein College of Medicine, Bronx, New York, USA.
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D000368:Aged; D002908:Chronic Disease; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000628:therapy; D004491:Edrophonium / Q000008:administration & dosage; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000175:diagnosis; D006435:Renal Dialysis
D004491:Edrophonium