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Sakai W, Matsui N, Ishida M, et al. Late-onset myasthenia gravis is predisposed to become generalized in the elderly. eNeurologicalSci. 2016;2:17-20doi: 10.1016/j.ensci.2016.02.004.
Sakai, W., Matsui, N., Ishida, M., Furukawa, T., Miyazaki, Y., Fujita, K., Miyamoto, R., Yamamoto, N., Sako, W., Sato, K., Kondo, K., Nishida, Y., Mitsui, T., Izumi, Y., & Kaji, R. (2016). Late-onset myasthenia gravis is predisposed to become generalized in the elderly. eNeurologicalSci, 217-20. https://doi.org/10.1016/j.ensci.2016.02.004
Sakai, Waka, et al. "Late-onset myasthenia gravis is predisposed to become generalized in the elderly." eNeurologicalSci vol. 2 (2016): 17-20. doi: https://doi.org/10.1016/j.ensci.2016.02.004
Sakai W, Matsui N, Ishida M, Furukawa T, Miyazaki Y, Fujita K, Miyamoto R, Yamamoto N, Sako W, Sato K, Kondo K, Nishida Y, Mitsui T, Izumi Y, Kaji R. Late-onset myasthenia gravis is predisposed to become generalized in the elderly. eNeurologicalSci. 2016 Feb 11;2:17-20. doi: 10.1016/j.ensci.2016.02.004. eCollection 2016 Mar. PMID: 29473057; PMCID: PMC5818137.
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eNeurologicalSci. 2016 Feb 11;2:17-20. doi: 10.1016/j.ensci.2016.02.004. eCollection 2016 Mar.

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

eNeurologicalSci

Waka Sakai, Naoko Matsui, Mitsuyo Ishida, Takahiro Furukawa, Yoshimichi Miyazaki, Koji Fujita, Ryosuke Miyamoto, Nobuaki Yamamoto, Wataru Sako, Kenta Sato, Kazuya Kondo, Yoshihiko Nishida, Takao Mitsui, Yuishin Izumi, Ryuji Kaji

Affiliations

  1. Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
  2. Department of Neurology, Itsuki Hospital, Tokushima, Japan.
  3. Department of Oncological Medical Services, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
  4. Department of Neurology and Department of Clinical Research, Tokushima, National Hospital, Yoshinogawa, Japan.

PMID: 29473057 PMCID: PMC5818137 DOI: 10.1016/j.ensci.2016.02.004

Abstract

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 (

CONCLUSIONS: Our study showed that elderly LOMG patients are more prone to severity, suggesting that they require aggressive immunomodulatory therapy.

Keywords: AChR, acetylcholine receptor; ChE-I, cholinesterase inhibitor; Crisis; DM, diabetes mellitus; EOMG, early-onset myasthenia gravis; Elderly; Hyperplasia; IVIg, intravenous immunoglobulin; LOMG, late-onset myasthenia gravis; Late-onset myasthenia gravis; MG-ADL, myasthenia gravis activities of daily living score; MGFA, Myasthenia Gravis Foundation of America; PE, plasmapheresis; PIS, MGFA post-intervention status; PSL, prednisolone; Steroid; Thymectomy

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