Mark A Hellmann1, Ronit Mosberg-Galili, Israel Steiner. 1. Department of Neurology, Rabin Medical Center, Beilinson Campus, Petach Tiqva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Abstract
OBJECTIVE: The objective of the study is to examine clinical, therapeutic and prognostic factors of myasthenia gravis (MG) in the elderly. PATIENTS AND METHODS: We reviewed all MG files of patients who attended the neuro-immunology clinic at Rabin Medical Center, Petah Tikva, Israel from January 1995 until September 2011 for demographic data, MG presentation, and course and response to treatment. Patients were classified as elderly if disease onset was above 69years. RESULTS: Out of 137 patients with MG, 29 developed MG after age 69. The 108 young onset patients had a male:female ratio of 0.9:1 whereas the eighth and ninth decade onset had a significant male predominance with ratios of 2.6:1 and 4.5:1 respectively. There was no difference in the presenting symptomatology and the rate of sero-negativity in the elderly patients when compared to the early onset patients was similar. The older patients had much less thymic pathology and their acetylcholine receptor (AChR) antibody titer was lower. This was associated with better response to therapy and a good prognosis. CONCLUSION: MG onset in the elderly is not uncommon, is more prevalent in males, is associated with lower titer of AChR antibodies, is readily responsive to therapy and carries a good prognosis.
OBJECTIVE: The objective of the study is to examine clinical, therapeutic and prognostic factors of myasthenia gravis (MG) in the elderly. PATIENTS AND METHODS: We reviewed all MG files of patients who attended the neuro-immunology clinic at Rabin Medical Center, Petah Tikva, Israel from January 1995 until September 2011 for demographic data, MG presentation, and course and response to treatment. Patients were classified as elderly if disease onset was above 69years. RESULTS: Out of 137 patients with MG, 29 developed MG after age 69. The 108 young onset patients had a male:female ratio of 0.9:1 whereas the eighth and ninth decade onset had a significant male predominance with ratios of 2.6:1 and 4.5:1 respectively. There was no difference in the presenting symptomatology and the rate of sero-negativity in the elderly patients when compared to the early onset patients was similar. The older patients had much less thymic pathology and their acetylcholine receptor (AChR) antibody titer was lower. This was associated with better response to therapy and a good prognosis. CONCLUSION:MG onset in the elderly is not uncommon, is more prevalent in males, is associated with lower titer of AChR antibodies, is readily responsive to therapy and carries a good prognosis.
Authors: Elena Cortés-Vicente; Rodrigo Álvarez-Velasco; Sonia Segovia; Carmen Paradas; Carlos Casasnovas; Antonio Guerrero-Sola; Julio Pardo; Alba Ramos-Fransi; Teresa Sevilla; Adolfo López de Munain; Maria Teresa Gómez; Ivonne Jericó; Gerardo Gutiérrez-Gutiérrez; Ana Lara Pelayo-Negro; María Asunción Martín; María Dolores Mendoza; Germán Morís; Ricard Rojas-Garcia; Jordi Díaz-Manera; Luis Querol; Eduard Gallardo; Beatriz Vélez; María Antonia Albertí; Lucía Galán; Tania García-Sobrino; Alicia Martínez-Piñeiro; Ana Lozano-Veintimilla; Roberto Fernández-Torrón; Ángel Cano-Abascal; Isabel Illa Journal: Neurology Date: 2020-02-18 Impact factor: 9.910