الفهرس | Only 14 pages are availabe for public view |
Abstract Background: The clinical course of myasthenia gravis (MG) is variable, and spontaneous remission is still not common as well as predictors and prognostic factors for relapse or secondary generalization of ocular myasthenia gravis remain deficiently clear. In this study we attempt to explore clinical predictors for the Myasthenia Gravis prognosis for better recognition of the disease course and effective management. Objective: Determine clinical predictors for the prognosis of myasthenia gravis. Patients and Methods: This case control study was conducted on 60 patients (30 relapsed and 30 non-relapsed) were normal at birth and later developed Fluctuating muscle weakness with Positive acetylcholine receptor antibody, positive decrement in the repetitive nerve stimulation or positive response to pyridostigmine. They were recruited from Neuromuscular Clinic at Ain Shams University Hospitals. Results: The majority of patients in the non-relapsed group their age of onset were less than forty years old, while the majority of patients in the relapsed group showed age of onset more than forty and yet it was found to more evident in the male patients. Age of disease onset is a significant predictor of MG relapse and early age at onset is predictive of a better prognosis. MGFA classification was found higher in the relapsed group, while patients classified low (ex: Class II B) show decrease in risk of relapse. Reaching statistically significant the higher class the higher risk of relapse (p-value0.021). The majority of patients with thymus hyperplasia and all patients with thymoma were in the relapsed group reaching highly statistically significant with p-value <0.001.Thymus hyperplasia and thymoma were risk factors that could contribute to MG relapse. The majority of the patients with associated autoimmune diseases were in the relapsed group (90.9%) reaching highly statistically significance with p-value 0.003.Concluding that the association with other autoimmune disease contribute to MG relapse Conclusion: Thymus hyperplasia and thymoma and other autoimmune diseases were risk factors that could contribute to MG relapse. Age of disease onset and MGFA classification are a significant predictor of MG relapse. |