Abstract |
Guanidine hydrochloride is known to be highly effective in the symptomatic treatment of the Lambert-Eaton myasthenic syndrome (LEMS). However, because of its potentially dangerous side reactions of hematologic abnormalities and renal insufficiency, 3,4-diaminopyridine, which is not readily available in the United States, is recommended as the preferred drug for LEMS. We used low-dose guanidine and pyridostigmine combination therapy in 9 patients with LEMS and analyzed its long-term safety and effectiveness. In all patients, a liberal amount of pyridostigmine was used, while daily guanidine dose was kept below 1000 mg a day, and guanidine was given between pyridostigmine dosings. This combination therapy was used for 3-102 months (mean: 34.1 months) and improved clinical status in all patients. Although guanidine had to be discontinued due to severe gastrointestinal symptoms in 3 cases, no serious side reactions such as bone marrow suppressions or signs of renal insufficiency developed in any case. Thus, we conclude that low-dose guanidine therapy is relatively safe and effective for long-term symptomatic treatment of LEMS when it is combined with pyridostigmine.
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Authors | S J Oh, D S Kim, T C Head, G C Claussen |
Journal | Muscle & nerve
(Muscle Nerve)
Vol. 20
Issue 9
Pg. 1146-52
(Sep 1997)
ISSN: 0148-639X [Print] United States |
PMID | 9270671
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Cholinesterase Inhibitors
- Guanidines
- Guanidine
- Pyridostigmine Bromide
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Topics |
- Adult
- Aged
- Cholinesterase Inhibitors
(administration & dosage, adverse effects, therapeutic use)
- Dose-Response Relationship, Drug
- Electrophysiology
- Female
- Guanidine
- Guanidines
(administration & dosage, adverse effects, therapeutic use)
- Humans
- Lambert-Eaton Myasthenic Syndrome
(complications, drug therapy, physiopathology)
- Male
- Middle Aged
- Neoplasms
(complications, therapy)
- Pyridostigmine Bromide
(administration & dosage, adverse effects, therapeutic use)
- Time Factors
- Treatment Outcome
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