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首页> 外文期刊>Journal of neurology >Characteristics of late-onset myasthenia gravis
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Characteristics of late-onset myasthenia gravis

机译：迟发性重症肌无力的特征

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An increasing incidence of myasthenia gravis (MG) has been reported in the elderly, but the full clinical ramifications of late-onset myasthenia gravis (LOMG) remain unclear. We describe the clinical features of our cohort of patients withMGwith an emphasis on an onset after the age of 50. This was a retrospective analysis of medical records of a cohort of patients followed in two tertiary neuromuscular clinics and comparison of early onset MG (EOMG) versusLOMG. There were 174 patients with a mean age of onset of 55.2 ± 19.1 years, and 44 % were women. Late onset of myasthenia gravis after age 50 was reported in 114 patients (66 %). Anti-AChR antibody titerswere elevated in 78%of patients (65%with EOMG vs. 85%with LOMG; p = 0.003), and frequency of elevated titers of anti-MuSK antibodies was similar in both groups (present in 38 % of all tested seronegative patients). Myasthenic crisis was equally common in generalized EOMG and LOMG (13 %). Ocular MG was more common in LOMG compared to EOMG (40 vs. 18 %, p = 0.021). Diabetes was more prevalent with LOMG (27 vs. 5 %; p = 0.0002). Overlapping clinical features of EOMG and LOMG are consistent with a continuous clinical spectrum of a single condition, with more frequent occurrence of seropositive and ocularMGwith a late onset.A higher burden of comorbidities, such as diabetes mellitus, may warrant a modified approach to treatment of myasthenia in LOMG. However, overall disease severity may not be higher with aging. These observations have implications for design of MG clinical trials and outcomes studies.
机译：老年人重症肌无力（MG）的发病率有所增加，但迟发性重症肌无力（LOMG）的全部临床后果仍不清楚。我们描述了我们这组患有MG的患者的临床特征，重点是50岁以后的发作。这是对两家三级神经肌肉诊所随访的一组患者的病历进行的回顾性分析，并对早期发作MG（EOMG）进行了比较vsLOMG。有174例患者的平均发病年龄为55.2±19.1岁，女性为44％。据报道114例患者中66岁重症肌无力迟发。抗AChR抗体滴度在78％的患者中升高（EOMG为65％，而LOMG为85％; p = 0.003），两组中抗MuSK抗体滴度升高的频率相似（占所有患者的38％测试过的血清阴性患者）。肌无力危象在全身性EOMG和LOMG中同样普遍（13％）。与EOMG相比，LOMG中眼部MG更常见（40％vs. 18％，p = 0.021）。糖尿病在LOMG中更为普遍（27比5％; p = 0.0002）。 EOMG和LOMG的重叠临床特征与单一病状的连续临床表现相符，血清阳性和眼部MG的发生频率更高，起病较晚，合并症的负担较高，例如糖尿病，可能需要采用改良的方法来治疗LOMG中的肌无力。但是，随着年龄的增长，总体疾病严重程度可能不会更高。这些观察结果对MG临床试验和结果研究的设计具有影响。

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