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

• Material Type: 博士論文
• ISSN: 2405-6502
• Title: Late-onset myasthenia gravis is predisposed to become generalized in the elderly
• Volume: 2
• 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
• Degree grantor/type: 徳島大学
• Date Granted: 2017-09-28
• Date Granted (W3CDTF): 2017-09-28
• Dissertation Number: 甲第3102号
• Degree Type: 博士（医学）
• Conferring No. (Dissertation): 甲第3102号
• 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.
• DOI: info:doi/10.1016/j.ensci.2016.02.004; https://doi.org/info:doi/10.1016/j.ensci.2016.02.004
• Persistent ID (NDL): info:ndljp/pid/11008885; https://dl.ndl.go.jp/pid/11008885
• Collection: 障害者向け資料
• Collection (Materials For Handicapped People:1): テキストデータ
• Collection (particular): 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• Acquisition Basis: 博士論文（自動収集）
• Date Accepted (W3CDTF): 2018-01-02T17:18:43+09:00
• Format (IMT): application/pdf
• Access Restrictions: 国立国会図書館内限定公開
• Service for the Digitized Contents Transmission Service: 図書館・個人送信対象外
• Availability of remote photoduplication service: 可
• Periodical Title (URI): http://repo.lib.tokushima-u.ac.jp/110923
• Data Provider (Database): 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp