Cargando…

Late-onset myasthenia gravis is predisposed to become generalized in the elderly

OBJECTIVE: The continuous increase in the number of patients presenting with late-onset myasthenia gravis (LOMG) underscores the need for a better understanding of the clinical course and the establishment of an optimal therapeutic strategy. We aimed to clarify factors associated with clinical outco...

Descripción completa

Detalles Bibliográficos
Autores principales: Sakai, Waka, Matsui, Naoko, Ishida, Mitsuyo, Furukawa, Takahiro, Miyazaki, Yoshimichi, Fujita, Koji, Miyamoto, Ryosuke, Yamamoto, Nobuaki, Sako, Wataru, Sato, Kenta, Kondo, Kazuya, Nishida, Yoshihiko, Mitsui, Takao, Izumi, Yuishin, Kaji, Ryuji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818137/
https://www.ncbi.nlm.nih.gov/pubmed/29473057
http://dx.doi.org/10.1016/j.ensci.2016.02.004
_version_ 1783300979583614976
author Sakai, Waka
Matsui, Naoko
Ishida, Mitsuyo
Furukawa, Takahiro
Miyazaki, Yoshimichi
Fujita, Koji
Miyamoto, Ryosuke
Yamamoto, Nobuaki
Sako, Wataru
Sato, Kenta
Kondo, Kazuya
Nishida, Yoshihiko
Mitsui, Takao
Izumi, Yuishin
Kaji, Ryuji
author_facet Sakai, Waka
Matsui, Naoko
Ishida, Mitsuyo
Furukawa, Takahiro
Miyazaki, Yoshimichi
Fujita, Koji
Miyamoto, Ryosuke
Yamamoto, Nobuaki
Sako, Wataru
Sato, Kenta
Kondo, Kazuya
Nishida, Yoshihiko
Mitsui, Takao
Izumi, Yuishin
Kaji, Ryuji
author_sort Sakai, Waka
collection PubMed
description OBJECTIVE: The continuous increase in the number of patients presenting with late-onset myasthenia gravis (LOMG) underscores the need for a better understanding of the clinical course and the establishment of an optimal therapeutic strategy. We aimed to clarify factors associated with clinical outcomes in LOMG. METHODS: We retrospectively reviewed the clinical profiles of 40 patients with early-onset MG (EOMG) (onset age: 49 years or younger), 30 patients with non-elderly LOMG (onset age: 50–64 years), and 28 patients with elderly LOMG (onset age: 65 years or older) and compared the subgroups according to onset age and thymus status. The evaluated parameters were MGFA classification before treatment, MG-ADL score, complicating diseases, antibody titer, treatment, and MGFA post-intervention status. RESULTS: Elderly LOMG patients showed transition to generalized symptoms at a higher frequency and underwent thymectomy less frequently than EOMG and non-elderly LOMG patients (p < 0.001). The frequencies of crisis and plasmapheresis were significantly lower in thymectomized LOMG patients without thymoma than in thymectomized LOMG patients with thymoma or non-thymectomized LOMG patients (p < 0.01, P < 0.05, respectively). However, the outcome was not significantly different. All of the thymectomized LOMG patients without thymoma presenting with hyperplasia or thymic cyst had a favorable clinical course. CONCLUSIONS: Our study showed that elderly LOMG patients are more prone to severity, suggesting that they require aggressive immunomodulatory therapy.
format Online
Article
Text
id pubmed-5818137
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-58181372018-02-22 Late-onset myasthenia gravis is predisposed to become generalized in the elderly Sakai, Waka Matsui, Naoko Ishida, Mitsuyo Furukawa, Takahiro Miyazaki, Yoshimichi Fujita, Koji Miyamoto, Ryosuke Yamamoto, Nobuaki Sako, Wataru Sato, Kenta Kondo, Kazuya Nishida, Yoshihiko Mitsui, Takao Izumi, Yuishin Kaji, Ryuji eNeurologicalSci Original Article OBJECTIVE: The continuous increase in the number of patients presenting with late-onset myasthenia gravis (LOMG) underscores the need for a better understanding of the clinical course and the establishment of an optimal therapeutic strategy. We aimed to clarify factors associated with clinical outcomes in LOMG. METHODS: We retrospectively reviewed the clinical profiles of 40 patients with early-onset MG (EOMG) (onset age: 49 years or younger), 30 patients with non-elderly LOMG (onset age: 50–64 years), and 28 patients with elderly LOMG (onset age: 65 years or older) and compared the subgroups according to onset age and thymus status. The evaluated parameters were MGFA classification before treatment, MG-ADL score, complicating diseases, antibody titer, treatment, and MGFA post-intervention status. RESULTS: Elderly LOMG patients showed transition to generalized symptoms at a higher frequency and underwent thymectomy less frequently than EOMG and non-elderly LOMG patients (p < 0.001). The frequencies of crisis and plasmapheresis were significantly lower in thymectomized LOMG patients without thymoma than in thymectomized LOMG patients with thymoma or non-thymectomized LOMG patients (p < 0.01, P < 0.05, respectively). However, the outcome was not significantly different. All of the thymectomized LOMG patients without thymoma presenting with hyperplasia or thymic cyst had a favorable clinical course. CONCLUSIONS: Our study showed that elderly LOMG patients are more prone to severity, suggesting that they require aggressive immunomodulatory therapy. Elsevier 2016-02-11 /pmc/articles/PMC5818137/ /pubmed/29473057 http://dx.doi.org/10.1016/j.ensci.2016.02.004 Text en © 2016 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Sakai, Waka
Matsui, Naoko
Ishida, Mitsuyo
Furukawa, Takahiro
Miyazaki, Yoshimichi
Fujita, Koji
Miyamoto, Ryosuke
Yamamoto, Nobuaki
Sako, Wataru
Sato, Kenta
Kondo, Kazuya
Nishida, Yoshihiko
Mitsui, Takao
Izumi, Yuishin
Kaji, Ryuji
Late-onset myasthenia gravis is predisposed to become generalized in the elderly
title Late-onset myasthenia gravis is predisposed to become generalized in the elderly
title_full Late-onset myasthenia gravis is predisposed to become generalized in the elderly
title_fullStr Late-onset myasthenia gravis is predisposed to become generalized in the elderly
title_full_unstemmed Late-onset myasthenia gravis is predisposed to become generalized in the elderly
title_short Late-onset myasthenia gravis is predisposed to become generalized in the elderly
title_sort late-onset myasthenia gravis is predisposed to become generalized in the elderly
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818137/
https://www.ncbi.nlm.nih.gov/pubmed/29473057
http://dx.doi.org/10.1016/j.ensci.2016.02.004
work_keys_str_mv AT sakaiwaka lateonsetmyastheniagravisispredisposedtobecomegeneralizedintheelderly
AT matsuinaoko lateonsetmyastheniagravisispredisposedtobecomegeneralizedintheelderly
AT ishidamitsuyo lateonsetmyastheniagravisispredisposedtobecomegeneralizedintheelderly
AT furukawatakahiro lateonsetmyastheniagravisispredisposedtobecomegeneralizedintheelderly
AT miyazakiyoshimichi lateonsetmyastheniagravisispredisposedtobecomegeneralizedintheelderly
AT fujitakoji lateonsetmyastheniagravisispredisposedtobecomegeneralizedintheelderly
AT miyamotoryosuke lateonsetmyastheniagravisispredisposedtobecomegeneralizedintheelderly
AT yamamotonobuaki lateonsetmyastheniagravisispredisposedtobecomegeneralizedintheelderly
AT sakowataru lateonsetmyastheniagravisispredisposedtobecomegeneralizedintheelderly
AT satokenta lateonsetmyastheniagravisispredisposedtobecomegeneralizedintheelderly
AT kondokazuya lateonsetmyastheniagravisispredisposedtobecomegeneralizedintheelderly
AT nishidayoshihiko lateonsetmyastheniagravisispredisposedtobecomegeneralizedintheelderly
AT mitsuitakao lateonsetmyastheniagravisispredisposedtobecomegeneralizedintheelderly
AT izumiyuishin lateonsetmyastheniagravisispredisposedtobecomegeneralizedintheelderly
AT kajiryuji lateonsetmyastheniagravisispredisposedtobecomegeneralizedintheelderly