Refractory myasthenia gravis – clinical profile, comorbidities and response to rituximab
Introduction: Myasthenia gravis (MG) is an antibody mediated autoimmune neuromuscular disorder characterized by fatigable muscle weakness. A proportion of myasthenia gravis patients are classified as refractory due to non responsiveness to conventional treatment. This retrospective study was done to...
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| Format: | Article |
| Language: | deu |
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German Medical Science GMS Publishing House
2016-10-01
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| Series: | GMS German Medical Science |
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| Online Access: | http://www.egms.de/static/en/journals/gms/2016-14/000239.shtml |
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| author | Sudulagunta, Sreenivasa Rao Sepehrar, Mona Sodalagunta, Mahesh Babu Settikere Nataraju, Aravinda Bangalore Raja, Shiva Kumar Sathyanarayana, Deepak Gummadi, Siddharth Burra, Hemanth Kumar |
| author_facet | Sudulagunta, Sreenivasa Rao Sepehrar, Mona Sodalagunta, Mahesh Babu Settikere Nataraju, Aravinda Bangalore Raja, Shiva Kumar Sathyanarayana, Deepak Gummadi, Siddharth Burra, Hemanth Kumar |
| author_sort | Sudulagunta, Sreenivasa Rao |
| collection | DOAJ |
| description | Introduction: Myasthenia gravis (MG) is an antibody mediated autoimmune neuromuscular disorder characterized by fatigable muscle weakness. A proportion of myasthenia gravis patients are classified as refractory due to non responsiveness to conventional treatment. This retrospective study was done to evaluate clinical profile, epidemiological, laboratory, and features of patients with MG and mode of management using rituximab and complications.Methods: Data of myasthenia gravis patients admitted or presented to outpatient department (previous medical records) with MG between January 2008 and January 2016 were included. A total of 512 patients fulfilled the clinical and diagnostic criteria of myasthenia gravis of which 76 patients met the diagnostic certainty for refractory myasthenia gravis and were evaluated. Results: Out of 76 refractory MG patients, 53 (69.73%) patients fulfilled all the three defined criteria. The median age of onset of the refractory MG group was 36 years with a range of 27–53 years. In our study 25 patients (32.89%) belonged to the age group of 21–30 years. Anti-MuSK antibodies were positive in 8 non-refractory MG patients (2.06%) and 36 refractory MG patients (47.36%). Mean HbA was found to be 8.6±2.33. The dose of administered prednisone decreased by a mean of 59.7% (=3.3x10) to 94.6% (=2.2x10) after the third cycle of rituximab treatment.Conclusion: The refractory MG patients are most commonly female with an early age of onset, anti-MuSK antibodies, and thymomas. Refractory MG patients have higher prevalence and poor control (HbA >8%) of diabetes mellitus and dyslipidemia probably due to increased steroid usage. Rituximab is very efficient in treatment of refractory MG with adverse effects being low. |
| first_indexed | 2024-12-10T22:25:17Z |
| format | Article |
| id | doaj.art-9847946d201e4a16b1941c7574223aae |
| institution | Directory Open Access Journal |
| issn | 1612-3174 |
| language | deu |
| last_indexed | 2024-12-10T22:25:17Z |
| publishDate | 2016-10-01 |
| publisher | German Medical Science GMS Publishing House |
| record_format | Article |
| series | GMS German Medical Science |
| spelling | doaj.art-9847946d201e4a16b1941c7574223aae2022-12-22T01:31:12ZdeuGerman Medical Science GMS Publishing HouseGMS German Medical Science1612-31742016-10-0114Doc1210.3205/000239Refractory myasthenia gravis – clinical profile, comorbidities and response to rituximabSudulagunta, Sreenivasa Rao0Sepehrar, Mona1Sodalagunta, Mahesh Babu2Settikere Nataraju, Aravinda3Bangalore Raja, Shiva Kumar4Sathyanarayana, Deepak5Gummadi, Siddharth6Burra, Hemanth Kumar7Columbia Asia Hospital, Kirloskar Business Park, Hebbal, Bangalore, IndiaBaptist Hospital, Bangalore, IndiaKS. Hegde Medical College, Mangalore, IndiaColumbia Asia Hospital, Kirloskar Business Park, Hebbal, Bangalore, IndiaDepartment of General Medicine, Dr.B.R.Ambedkar Medical College, Bangalore, IndiaColumbia Asia Hospital, Kirloskar Business Park, Hebbal, Bangalore, IndiaColumbia Asia Hospital, Kirloskar Business Park, Hebbal, Bangalore, IndiaColumbia Asia Hospital, Kirloskar Business Park, Hebbal, Bangalore, IndiaIntroduction: Myasthenia gravis (MG) is an antibody mediated autoimmune neuromuscular disorder characterized by fatigable muscle weakness. A proportion of myasthenia gravis patients are classified as refractory due to non responsiveness to conventional treatment. This retrospective study was done to evaluate clinical profile, epidemiological, laboratory, and features of patients with MG and mode of management using rituximab and complications.Methods: Data of myasthenia gravis patients admitted or presented to outpatient department (previous medical records) with MG between January 2008 and January 2016 were included. A total of 512 patients fulfilled the clinical and diagnostic criteria of myasthenia gravis of which 76 patients met the diagnostic certainty for refractory myasthenia gravis and were evaluated. Results: Out of 76 refractory MG patients, 53 (69.73%) patients fulfilled all the three defined criteria. The median age of onset of the refractory MG group was 36 years with a range of 27–53 years. In our study 25 patients (32.89%) belonged to the age group of 21–30 years. Anti-MuSK antibodies were positive in 8 non-refractory MG patients (2.06%) and 36 refractory MG patients (47.36%). Mean HbA was found to be 8.6±2.33. The dose of administered prednisone decreased by a mean of 59.7% (=3.3x10) to 94.6% (=2.2x10) after the third cycle of rituximab treatment.Conclusion: The refractory MG patients are most commonly female with an early age of onset, anti-MuSK antibodies, and thymomas. Refractory MG patients have higher prevalence and poor control (HbA >8%) of diabetes mellitus and dyslipidemia probably due to increased steroid usage. Rituximab is very efficient in treatment of refractory MG with adverse effects being low.http://www.egms.de/static/en/journals/gms/2016-14/000239.shtmlmyasthenia gravisrefractoryrituximab |
| spellingShingle | Sudulagunta, Sreenivasa Rao Sepehrar, Mona Sodalagunta, Mahesh Babu Settikere Nataraju, Aravinda Bangalore Raja, Shiva Kumar Sathyanarayana, Deepak Gummadi, Siddharth Burra, Hemanth Kumar Refractory myasthenia gravis – clinical profile, comorbidities and response to rituximab GMS German Medical Science myasthenia gravis refractory rituximab |
| title | Refractory myasthenia gravis – clinical profile, comorbidities and response to rituximab |
| title_full | Refractory myasthenia gravis – clinical profile, comorbidities and response to rituximab |
| title_fullStr | Refractory myasthenia gravis – clinical profile, comorbidities and response to rituximab |
| title_full_unstemmed | Refractory myasthenia gravis – clinical profile, comorbidities and response to rituximab |
| title_short | Refractory myasthenia gravis – clinical profile, comorbidities and response to rituximab |
| title_sort | refractory myasthenia gravis clinical profile comorbidities and response to rituximab |
| topic | myasthenia gravis refractory rituximab |
| url | http://www.egms.de/static/en/journals/gms/2016-14/000239.shtml |
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