scholarly journals Clinical features of myasthenia gravis in elderly and senile patients

2020 ◽  
Vol 22 ◽  
pp. 01018
Author(s):  
Larisa Volkova ◽  
Marina Toporkova ◽  
Alla Galunova ◽  
Lidia Sokolova
Keyword(s):  
Elderly Patients ◽  
Myasthenia Gravis ◽  
Old Age ◽  
Clinical Features ◽  
Late Onset ◽  
Diagnostic Errors ◽  
Diagnosis And Treatment ◽  
Timely Diagnosis ◽  
Definition Of

The prevalence of myasthenia gravis is 10-24 cases per 100, 000 population. The debut of the disease is possible at any age: from infancy to old age. In the literature, the definition of “myasthenia gravis with late onset” – at the age of 60 years and older, which is 20-46% of all cases. In this regard, the disease is often combined with a burdened somatic history, which makes it difficult to timely diagnosis and treatment. This group of elderly patients accounts for the majority of diagnostic errors in the diagnosis of myasthenia gravis. This study is devoted to the study of the features of the onset and course of myasthenia gravis in elderly and senile people.

scholarly journals Outcome measures and treatment effectiveness in late onset myasthenia gravis

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Francesca Pasqualin ◽  
Silvia V. Guidoni ◽  
Mario Ermani ◽  
Elena Pegoraro ◽  
Domenico M. Bonifati
Keyword(s):  
Side Effects ◽  
Myasthenia Gravis ◽  
Outcome Measures ◽  
Clinical Features ◽  
Early Onset ◽  
Treatment Effectiveness ◽  
Late Onset ◽  
Positive Outcome ◽  
Response To Treatment

Abstract Background Recently different subtypes of myasthenia gravis (MG) have been described. They differ for clinical features and pathogenesis but the prognosis and response to treatment is less clear. The aim of the study was to evaluate outcome and treatment effectiveness including side effects in late onset MG (LOMG) compared with early onset MG (EOMG). Methods We analysed retrospectively 208 MG patients. Clinical features were recorded as well as treatment and side effects. Outcome at the last follow-up was evaluated with MGSTI and MGPIS scales. Results The 208 patients included were classified as follow: 36 ocular MG, 40 EOMG, 72 LOMG, 25 thymoma-associated, 14 anti-MuSK and 21 double seronegative. Similar positive outcome was achieved in either early and late onset subgroup. We found pharmacological remission and minimal manifestations at the MGFA-PIS in the 95% and 94,4% of EOMG and LOMG respectively but in LOMG a lower dose of immunosuppressors (MGSTI< 2) was required compared to EOMG (p = 0,048). Severe side effects were present in a small percentage of patients in both group but diabetes was more frequent in LOMG vs EOMG (2,2% vs 5%, p = 0.017). Conclusions Despite LOMG has more comorbidities that might interfere with treatment and outcome, therapeutic management does not seem to differ between EOMG and LOMG. A similar positive outcome was seen in both subgroups but LOMG group seems to require lower doses of medication to control symptoms.

Clinical features of the late onset myasthenia gravis in the Osaka Medical College Hospital

2017 ◽  
Vol 381 ◽  
pp. 1086-1087
Author(s):  
Y. Yoshimoto ◽  
A. Tsukahara ◽  
K. Unoda ◽  
K. Yamane ◽  
S. Ishida ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Clinical Features ◽  
Late Onset ◽  
Medical College Hospital ◽  
Osaka Medical College ◽  
College Hospital ◽  
Medical College

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

2019 ◽  
Vol 120 (1) ◽  
pp. 133-140
Author(s):  
Senay Yildiz Celik ◽  
Hacer Durmus ◽  
Vuslat Yilmaz ◽  
Guher Saruhan Direskeneli ◽  
Yesim Gulsen Parman ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Clinical Features ◽  
Late Onset

scholarly journals Main clinic and epidemiological factors of myasthenia in Leningrad region

2015 ◽  
Vol 22 (4) ◽  
pp. 40-43 ◽  
Author(s):  
L. G. Zaslavsky ◽  
A. B. Hurshilov
Keyword(s):  
Myasthenia Gravis ◽  
Rare Disease ◽  
Old Age ◽  
Clinical Features ◽  
Disease Onset ◽  
Leningrad Region ◽  
Age Group ◽  
Epidemiological Factors ◽  
Number Of Patients ◽  
Regions Of Russia

Objective: to conduct a study of the basic epidemiological and clinical data of myasthenia in Leningrad region. The analysis of inpatient and outpatient charts of all patients with myasthenia, who were treated at the neurology department of the Leningrad Regional Clinical Hospital (LOKB) from 2003 to 2012. The estimation of incidence and prevalence of the disease per 100 000 population, the basic gender-age characteristics and clinical features of myasthenia in Leningrad region. According to the findings myasthenia gravis is not a rare disease, the prevalence of myasthenia gravis in the whole area is 4.6 cases, the average incidence was 0.29 cases per 100 000 population. The prevalence of myasthenia gravis in Leningrad region is lower than in other regions of Russia. Among patients women predominate in the age group 45-59 years, and there is a significant number of patients with disease onset in middle and old age.

scholarly journals Analysis of clinical manifestations and diagnosis of late-onset myasthenia gravis

2020 ◽  
Vol 10 (1) ◽  
pp. 53-63
Author(s):  
A. N. Khalmurzina ◽  
T. M. Alekseeva ◽  
S. V. Lobzin ◽  
D. I. Rudenko ◽  
V. V. Kryuchkova
Keyword(s):  
Elderly Patients ◽  
Myasthenia Gravis ◽  
Late Onset ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Neuromuscular Diseases ◽  
The Elderly ◽  
Vascular Pathology ◽  
Common Symptom ◽  
Diagnostic Features

Introduction. Myasthenia gravis is one of the most common autoimmune neuromuscular diseases, the peak incidence is in the age of 20–40 years. However, studies show that throughout the world in recent decades there has been an increase in the prevalence and incidence of myasthenia gravis among older people.Purpose of the study – to evaluate the clinical manifestations and diagnostic features of myasthenia gravis in patients with an onset of diseases in the elderly.Materials and methods. The retrospective, non-interventional study included 315 patients over 18 years old with a reliable (3 out of 4 criteria) and an undoubted (4 out of 4 criteria) diagnosis of myasthenia gravis, the duration of the disease for up to 5 years, undergoing inpatient treatment from 2001 to 2017 years. The severity of the clinical manifestations of myasthenia gravis was assessed using the Myasthenia Gravis Foundation of America scale. We were taken into account the information about the first symptoms, duration of the period from the onset of the disease to the verification of the diagnosis, results of the examinations, the presence of concomitant diseases and treatment methods.Results. The most common symptom of myasthenia gravis in the group of patients with debut disease aged 60 years and older was ptosis (p <0.001). The crises and pathology of the thymus were less common in elderly patients (p <0.0001). The concentration of antibodies to acetylcholine receptors was the same (p = 0.05) among all patients. The level of antibodies to titin was increased in patients with lateonset (p = 0.0014). The presence of bronchopulmonary pathology made worse the course of myasthenia gravis in elderly people (p = 0.01), while cardiovascular and cerebrovascular diseases, as well as diabetes mellitus, did not occur (p >0.005). At the first examination in the group of elderly patients among the incorrectly diagnoses prevailed: stroke or decompensation of chronic cerebral ischemia (p = 0.0002). With a comparable duration and severity of myasthenia gravis in different age groups, the combination of anticholinesterase drugs, glucocorticosteroids and azathioprine (p = 0.01) at a lower daily dose (100 mg) was more often used for the treatment of elderly patients compared with young and middle-aged groups (150 mg) (p = 0.03).Conclusion. Diagnosis of myasthenia gravis in elderly patients presents the greatest difficulties, and symptoms of manifestation during initial treatment are often regarded as a manifestation of vascular pathology. Despite the presence of concomitant diseases characteristic of this age group, myasthenia gravis does not differ in the severity of the course. To achieve remission and compensation of symptoms, elderly patients do not need large doses of symptomatic and pathogenetic drugs.

A PROSPECTIVE CLINICAL AND IMMUNOLOGICAL STUDY OF LATE ONSET MYASTHENIA GRAVIS

2015 ◽  
Vol 86 (11) ◽  
pp. e4.49-e4
Author(s):  
Girija Sadalage ◽  
Saiju Jacob ◽  
Camilla Buckley ◽  
David Hilton-Jones ◽  
Angela Vincent ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Clinical Features ◽  
Late Onset ◽  
Single Fibre ◽  
Response To Treatment ◽  
Immunological Study ◽  
Serum Samples ◽  
Usual Practice ◽  
Composite Scores

There is an increasing incidence and prevalence of MG in older patients (>50 years) – defined as Late Onset Myasthenia Gravis (LOMG). This study aims to define the demographics, clinical features, response to treatment and immunological features which may distinguish LOMG from the early onset patients (who will also be recruited as controls).Who to refer?▸ All patients should be over the age of 18 years, able to provide informed consent.▸ The study aims to recruit patients who are willing to travel to one of the myasthenia clinics in Birmingham, Nottingham or Oxford▸ All patients with a new diagnosis of MG (or diagnosed in the last 12 months) prior to immunosuppression.▸ Diagnosis of MG based on typical clinical features and the presence of AChR or MuSK Abs, or evidence of neuromuscular transmission defect on single fibre EMG.What it involves for patients▸ Management will be as per usual practice▸ Annual serum samples at follow up with QoL and MG composite scores▸ Follow up for 5 years (3 years by the clinical research fellow and 2 years optionally by the local participating neurologists).

Consensus on the change of criteria for cure of acromegaly during the last decade

2011 ◽  
Vol 152 (18) ◽  
pp. 703-708 ◽  
Author(s):  
Gábor László Kovács ◽  
Judit Dénes ◽  
Erika Hubina ◽  
László Kovács ◽  
Sándor Czirják ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Factor ◽  
Disease Control ◽  
Short Communication ◽  
Consensus Statement ◽  
Diagnosis And Treatment ◽  
Clinical Aspects ◽  
Insulin Like Growth Factor ◽  
Criteria For Diagnosis ◽  
Definition Of

The Acromegaly Consensus Group redefined the consensus criteria for cure of acromegaly. 74 neurosurgeons and experienced endocrinologists summarized the latest results on diagnosis and treatment of acromegaly. In this consensus statement the reliable growth hormone and insulin-like growth factor-1 assays were established. Definition of disease control was discussed based on the available publications and evidence. This short communication summarizes the clinical aspects of consensus criteria for diagnosis and cure of acromegaly based on the original article. Orv. Hetil., 2011, 152, 703–708.

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