Ga. Khan et N. Bank, INTERPRETATION OF POSITIVE EDROPHONIUM (TENSILON) TEST IN PATIENTS WITH END-STAGE RENAL-DISEASE, Renal failure, 17(1), 1995, pp. 65-71
Many patients with end-stage renal disease (ESRD) have signs and sympt
oms 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 de
termine whether the patient has myasthenia gravis-the commonest of all
neuromuscular disorders-and administer the edrophonium (Tensilon) tes
t. An unequivocally positive response to the test must be interpreted
with caution in ESRD. However, the exact mechanism of a positive respo
nse is unclear but may be explained by metabolic abnormalities related
to end-stage renal disease, i.e., uremic toxins, disordered calcium m
etabolism, abnormal neuromuscular mechanism, associated neurological d
isorders, or myopathic processes in uremia, all of which can affect ne
uromuscular transmission.