Abstract：
Systemic lupus erythematosus (SLE) and myasthenia gravis (MG) are autoimmune diseases. Previous case reports and case series suggest an association may exist between these diseases, as well as an increased risk of SLE after thymectomy for MG. We undertook this study to determine whether SLE and MG were associated in large cohorts.
We searched the IBM Watson Health Explorys platform and the Department of Veterans Affairs Million Veteran Program (MVP) database for diagnoses of SLE and MG. In addition, we examined subjects enrolled in the Lupus Family Registry and Repository (LFRR) as well as controls for a diagnosis of MG.
Among 59,780,210 individuals captured in Explorys, there were 25,750 with MG and 65,370 with SLE. 370 subjects had both. Those with MG were >10 times more likely to have SLE than those without MG. Those with both diseases were more likely to be women, African American, and at a younger age than MG subjects without SLE. In addition, the MG patients who underwent thymectomy had an increased risk of SLE compared to MG patients who had not undergone thymectomy (OR 3.11, 95% CI: 2.12 to 4.55). Autoimmune diseases such as pernicious anemia and miscellaneous comorbidities such as chronic kidney disease were significantly more common in MG patients who developed SLE. In the MVP, SLE and MG were also significantly associated. Association of SLE and MG in a large SLE cohort with rigorous SLE classification confirmed the association of SLE with MG at a similar level.
While the number of patients with both MG and SLE is small, SLE and MG are strongly associated together in very large databases and a large SLE cohort.
We searched the IBM Watson Health Explorys platform and the Department of Veterans Affairs Million Veteran Program (MVP) database for diagnoses of SLE and MG. In addition, we examined subjects enrolled in the Lupus Family Registry and Repository (LFRR) as well as controls for a diagnosis of MG.
Among 59,780,210 individuals captured in Explorys, there were 25,750 with MG and 65,370 with SLE. 370 subjects had both. Those with MG were >10 times more likely to have SLE than those without MG. Those with both diseases were more likely to be women, African American, and at a younger age than MG subjects without SLE. In addition, the MG patients who underwent thymectomy had an increased risk of SLE compared to MG patients who had not undergone thymectomy (OR 3.11, 95% CI: 2.12 to 4.55). Autoimmune diseases such as pernicious anemia and miscellaneous comorbidities such as chronic kidney disease were significantly more common in MG patients who developed SLE. In the MVP, SLE and MG were also significantly associated. Association of SLE and MG in a large SLE cohort with rigorous SLE classification confirmed the association of SLE with MG at a similar level.
While the number of patients with both MG and SLE is small, SLE and MG are strongly associated together in very large databases and a large SLE cohort.
摘要：
背景：系统性红斑狼疮（SLE）和重症肌无力（MG）是自身免疫性疾病。以前的病例报告和病例系列表明，这些疾病之间可能存在关联，以及MG胸腺切除术后SLE的风险增加。我们进行了这项研究，以确定SLE和MG在大型队列中是否相关。
方法：我们搜索了IBMWatsonHealthExporys平台和退伍军人事务部百万退伍军人计划(MVP)数据库，以诊断SLE和MG。此外,我们检查了纳入狼疮家庭登记处(LFRR)的受试者以及诊断MG的对照.
结果：在探索中捕获的59,780,210个人中，MG患者为25,750，SLE患者为65,370。370名受试者都有。患有MG的人患SLE的可能性是没有MG的人的10倍以上。患有这两种疾病的人更有可能是女性，非洲裔美国人,年龄比没有SLE的MG受试者年轻。此外,与未接受胸腺切除术的MG患者相比,接受胸腺切除术的MG患者发生SLE的风险增加(OR3.11,95%CI:2.12~4.55).自身免疫性疾病如恶性贫血和其他合并症如慢性肾病在发展为SLE的MG患者中明显更常见。在MVP中,SLE和MG也显著相关。在具有严格SLE分类的大型SLE队列中，SLE和MG的关联证实了SLE与MG的关联处于相似水平。
结论：虽然患有MG和SLE的患者数量很少，SLE和MG在大型数据库和大型SLE队列中紧密相关。
方法：我们搜索了IBMWatsonHealthExporys平台和退伍军人事务部百万退伍军人计划(MVP)数据库，以诊断SLE和MG。此外,我们检查了纳入狼疮家庭登记处(LFRR)的受试者以及诊断MG的对照.
结果：在探索中捕获的59,780,210个人中，MG患者为25,750，SLE患者为65,370。370名受试者都有。患有MG的人患SLE的可能性是没有MG的人的10倍以上。患有这两种疾病的人更有可能是女性，非洲裔美国人,年龄比没有SLE的MG受试者年轻。此外,与未接受胸腺切除术的MG患者相比,接受胸腺切除术的MG患者发生SLE的风险增加(OR3.11,95%CI:2.12~4.55).自身免疫性疾病如恶性贫血和其他合并症如慢性肾病在发展为SLE的MG患者中明显更常见。在MVP中,SLE和MG也显著相关。在具有严格SLE分类的大型SLE队列中，SLE和MG的关联证实了SLE与MG的关联处于相似水平。
结论：虽然患有MG和SLE的患者数量很少，SLE和MG在大型数据库和大型SLE队列中紧密相关。
