%0 Journal Article
%T Late-onset myasthenia gravis is predisposed to become generalized in the elderly.
%A Sakai W
%A Matsui N
%A Ishida M
%A Furukawa T
%A Miyazaki Y
%A Fujita K
%A Miyamoto R
%A Yamamoto N
%A Sako W
%A Sato K
%A Kondo K
%A Nishida Y
%A Mitsui T
%A Izumi Y
%A Kaji R
%J eNeurologicalSci
%V 2
%N 0
%D Mar 2016
%M 29473057
暂无%R 10.1016/j.ensci.2016.02.004
%X <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>Elderly LOMG patients showed transition to generalized symptoms at a higher frequency and underwent thymectomy less 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.<BR><B>CONCLUSIONS: </B>Our study showed that elderly LOMG patients are more prone to severity, suggesting that they require aggressive immunomodulatory therapy.