Late-onset generalized myasthenia gravis: clinical features, treatment, and outcome

Late-onset myasthenia gravis (LOMG) is a unique MG subgroup. More information is needed on its subgroups such as non-thymomatous generalized LOMG. We evaluated the effect of demographic, clinical, and serological factors as well as different immunosuppressive modalities on outcome in generalized non...

Full description

Saved in:
Bibliographic Details
Published inActa neurologica Belgica Vol. 120; no. 1; pp. 133 - 140
Main Authors Yildiz Celik, Senay, Durmus, Hacer, Yilmaz, Vuslat, Saruhan Direskeneli, Guher, Gulsen Parman, Yesim, Serdaroglu Oflazer, Piraye, Deymeer, Feza
Format Journal Article
LanguageEnglish
Published Cham Springer International Publishing 01.02.2020
Subjects
Biomedical and Life Sciences
Biomedicine
Medicine/Public Health
Neurology
Neuroradiology
Neurosciences
Original Article
Myasthenia gravis
Treatment
Elderly
Late-onset
Online AccessGet full text

Cover

More Information
Summary:Late-onset myasthenia gravis (LOMG) is a unique MG subgroup. More information is needed on its subgroups such as non-thymomatous generalized LOMG. We evaluated the effect of demographic, clinical, and serological factors as well as different immunosuppressive modalities on outcome in generalized non-thymomatous LOMG with onset ≥ 50 years. Myasthenia Gravis Foundation of America (MGFA) Clinical Classification, MGFA postintervention score (MGFA PIS) and MG Composite scores were obtained to define the severity of disease and clinical outcome. In 95 patients with generalized non-thymomatous LOMG, 60 (63%) were men, 45 (47%) had mild disease, 80 (84%) were anti-AChR, and 56 (61%) were anti-titin positive. In those who received immunosuppressives and provided the clinical scores (84 patients), 50 (60%) had favorable outcome (MGFA PIS categories of complete stable remission, pharmacological remission and minimal manifestations) at the end of 3 years. Use of prednisone + azathioprine had significantly positive effect on outcome. The presence of anti-titin antibodies had no significant effect on severity and outcome. Five anti-MuSK-positive patients had favorable outcome. In conclusion, the presence of neither anti-titin nor anti-MuSK antibodies points to unfavorable outcome. Prednisone and azathioprine combination has beneficial effects in non-thymomatous generalized LOMG.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0300-9009
2240-2993
DOI:10.1007/s13760-019-01252-x