Clinical characteristics of late-onset myasthenia gravis
Objective: Late-onset myasthenia gravis (LOMG) often has comorbidities, and its initial symptoms may be ignored or misdiagnosed as other diseases. There were few large surveys on LOMG. Our study aimed to summarize clinical characteristics of LOMG to improve the rate of correct MG diagnosis. Methods:...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844024049247 |
| _version_ | 1797226635439636480 |
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| author | Chenjing Sun Zhuangzhuang Ren Xiuling Miao Yanxu Zheng Jun Zhang Xiaokun Qi Jianguo Liu Feng Qiu |
| author_facet | Chenjing Sun Zhuangzhuang Ren Xiuling Miao Yanxu Zheng Jun Zhang Xiaokun Qi Jianguo Liu Feng Qiu |
| author_sort | Chenjing Sun |
| collection | DOAJ |
| description | Objective: Late-onset myasthenia gravis (LOMG) often has comorbidities, and its initial symptoms may be ignored or misdiagnosed as other diseases. There were few large surveys on LOMG. Our study aimed to summarize clinical characteristics of LOMG to improve the rate of correct MG diagnosis. Methods: A retrospective cohort study included 240 LOMG patients with onset age ≥65 years old who were treated at PLA General Hospital from January 1, 2003 to January 1, 2023. Results: The male to female ratio was 1:1.2 (P = 0.699). MGFA clinical classification: Class I 31.3%, Class IIa 12.9%, Class IIb 51.3%, Class IIIa 0.8%, Class IIIb 0.8%, Class IV 0.4%, Class V2.5%. The onset symptom was ptosis in 78.8% and diplopia was in 18.8%. Swallowing dysfunction in the stage of LOMG was in 41.7%. The incidence of thymoma in LOMG was 14.2%. 85.4% of patients antibodies against the muscle acetylcholine receptor (AChR) are detected. The overall incidence of supramaximal repetitive nerve stimulation (Jolly test) was 57.1%, among which the highest positive rate (50.7%) was in the facial nerve. Jolly test of Class IIb was tested in the highest positive rate and Class I was in the lowest one (χ2 = 7.023, P = 0.030). Conclusion: There was no significant difference in the incidence of LOMG between males and females. The clinical manifestations were mainly Class I and Class II, and severe MG was rare. The most common onset symptom was ptosis. The incidence of LOMG with thymoma was low. Supramaximal repetitive nerve stimulation (Jolly test) of the facial nerve was the easiest to detect and Jolly test of Class IIb was tested in the highest positive rate and Class I was in the lowest one. |
| first_indexed | 2024-04-24T14:28:02Z |
| format | Article |
| id | doaj.art-8680b28b58864df0ab5691c2124c5918 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-04-24T14:28:02Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-8680b28b58864df0ab5691c2124c59182024-04-03T04:27:05ZengElsevierHeliyon2405-84402024-04-01107e28893Clinical characteristics of late-onset myasthenia gravisChenjing Sun0Zhuangzhuang Ren1Xiuling Miao2Yanxu Zheng3Jun Zhang4Xiaokun Qi5Jianguo Liu6Feng Qiu7Senior Department of Neurology, The First Medical Center of PLA General Hospital, Beijing, ChinaNavy Clinical College, the Fifth School of Clinical Medicine, Anhui Medical University, Hefei, 230032, Anhui Province, ChinaSenior Department of Neurology, The First Medical Center of PLA General Hospital, Beijing, ChinaXiangya School of Medicine, Central South University, 87 Xiangya Road, Changsha, Hunan 410000, ChinaThe Sixth Medical Center of PLA General Hospital, Beijing 100048, ChinaSenior Department of Neurology, The First Medical Center of PLA General Hospital, Beijing, China; Corresponding author. Xiaokun QiSenior Department of Neurology, The First Medical Center of PLA General Hospital, Beijing, China; Corresponding author. Jianguo LiuSenior Department of Neurology, The First Medical Center of PLA General Hospital, Beijing, China; Corresponding author. Feng QiuObjective: Late-onset myasthenia gravis (LOMG) often has comorbidities, and its initial symptoms may be ignored or misdiagnosed as other diseases. There were few large surveys on LOMG. Our study aimed to summarize clinical characteristics of LOMG to improve the rate of correct MG diagnosis. Methods: A retrospective cohort study included 240 LOMG patients with onset age ≥65 years old who were treated at PLA General Hospital from January 1, 2003 to January 1, 2023. Results: The male to female ratio was 1:1.2 (P = 0.699). MGFA clinical classification: Class I 31.3%, Class IIa 12.9%, Class IIb 51.3%, Class IIIa 0.8%, Class IIIb 0.8%, Class IV 0.4%, Class V2.5%. The onset symptom was ptosis in 78.8% and diplopia was in 18.8%. Swallowing dysfunction in the stage of LOMG was in 41.7%. The incidence of thymoma in LOMG was 14.2%. 85.4% of patients antibodies against the muscle acetylcholine receptor (AChR) are detected. The overall incidence of supramaximal repetitive nerve stimulation (Jolly test) was 57.1%, among which the highest positive rate (50.7%) was in the facial nerve. Jolly test of Class IIb was tested in the highest positive rate and Class I was in the lowest one (χ2 = 7.023, P = 0.030). Conclusion: There was no significant difference in the incidence of LOMG between males and females. The clinical manifestations were mainly Class I and Class II, and severe MG was rare. The most common onset symptom was ptosis. The incidence of LOMG with thymoma was low. Supramaximal repetitive nerve stimulation (Jolly test) of the facial nerve was the easiest to detect and Jolly test of Class IIb was tested in the highest positive rate and Class I was in the lowest one.http://www.sciencedirect.com/science/article/pii/S2405844024049247Myasthenia gravisLate-onset myasthenia gravisComorbiditiesMedicationClinical features |
| spellingShingle | Chenjing Sun Zhuangzhuang Ren Xiuling Miao Yanxu Zheng Jun Zhang Xiaokun Qi Jianguo Liu Feng Qiu Clinical characteristics of late-onset myasthenia gravis Heliyon Myasthenia gravis Late-onset myasthenia gravis Comorbidities Medication Clinical features |
| title | Clinical characteristics of late-onset myasthenia gravis |
| title_full | Clinical characteristics of late-onset myasthenia gravis |
| title_fullStr | Clinical characteristics of late-onset myasthenia gravis |
| title_full_unstemmed | Clinical characteristics of late-onset myasthenia gravis |
| title_short | Clinical characteristics of late-onset myasthenia gravis |
| title_sort | clinical characteristics of late onset myasthenia gravis |
| topic | Myasthenia gravis Late-onset myasthenia gravis Comorbidities Medication Clinical features |
| url | http://www.sciencedirect.com/science/article/pii/S2405844024049247 |
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