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

• Material Type: 博士論文
• Title: Late-onset myasthenia gravis is predisposed to become generalized in the elderly
• Author/Editor: Sakai, Waka; Matsui, Naoko; Ishida, Mitsuyo; Furukawa, Takahiro; Miyazaki, Yoshimichi; Fujita, Koji; Miyamoto, Ryosuke; Yamamoto, Nobuaki; Sako, Wataru; Sato, Kenta; Kondo, Kazuya; Nishida, Yoshihiko; Mitsui, Takao; Izumi, Yuishin; Kaji, Ryuji
• Author Heading: Sakai, Waka; Matsui, Naoko; Ishida, Mitsuyo; Furukawa, Takahiro; Miyazaki, Yoshimichi; Fujita, Koji; Miyamoto, Ryosuke; Yamamoto, Nobuaki; Sako, Wataru; Sato, Kenta; Kondo, Kazuya; Nishida, Yoshihiko; Mitsui, Takao; Izumi, Yuishin; Kaji, Ryuji
• Publication, Distribution, etc.: Elsevier
• Publication Date: 2016-02-11
• Publication Date (W3CDTF): 2016-02-11
• Alternative Title: 高齢で発症した重症筋無力症は重症化しやすい
• Periodical title: eNeurologicalSci
• No. or year of volume/issue: 2
• Volume: 2
• Pages: 17-20
• ISSN (Periodical Title): ISSN : 2405-6502
• Degree grantor/type: 徳島大学
• Date Granted: 2017-09-28
• Dissertation Number: 甲第3102号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Late-onset myasthenia gravis; Elderly; Crisis; Thymectomy; Hyperplasia; Steroid
• Target Audience: 一般
• Note (General): 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 thymectomyless frequently than EOMG and non-elderly LOMG patients (p < 0.001). The frequencies of crisis and plasmapheresis were significantly lower in thymectomized LOMG patients without thymoma than in thymectomized LOMG patients with thymoma or non-thymectomized LOMG patients (p < 0.01, P < 0.05, respectively). However, the outcome was not significantly different. All of the thymectomized LOMG patients without thymoma presenting with hyperplasia or thymic cyst had a favorable clinical course. Conclusions: Our study showed that elderly LOMG patients are more prone to severity, suggesting that they require aggressive immunomodulatory therapy.
• Format (IMT): application/pdf
• Access Restrictions: インターネット公開
• Rights (production): This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
• Related Material (DOI): 10.1016/j.ensci.2016.02.004
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 徳島大学 : 徳島大学機関リポジトリ

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