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Prognosis of ocular myasthenia in Korea: a retrospective multicenter analysis of 202 patients

Cited 27 time in Web of Science Cited 35 time in Scopus
Authors
Hong, Yoon-Ho; Kwon, Seok-Beom; Kim, Byung-Jo; Kim, Byoung Joon; Kim, Seung Hyun; Kim, Jong Kuk; Park, Kyung-Seok; Park, Ki-Jong; Sung, Jung-Joon; Sohn, Eun Hee; Lee, Yeong-Bae; Jeong, Dushin; Joo, In Soo; Choi, Byung-Ok; Choi, Young-Chul
Issue Date
2008-07-08
Publisher
Elsevier
Citation
J Neurol Sci. 2008;273(1-2):10-14
Keywords
AdultAgedAged, 80 and overAging/*pathologyAnalysis of VarianceFemaleHumansKorea/epidemiologyMaleMiddle AgedMyasthenia Gravis/*diagnosis/*epidemiologyPrognosisReceptors, Cholinergic/immunology/physiologyRetrospective StudiesStatistics, Nonparametric
Abstract
OBJECTIVES: The aims of this study were to obtain data on the frequency with which Korean patients with autoimmune myasthenia gravis (MG) present solely with ocular disturbances and progress to develop generalized disease and to identify the prognostic factors associated with secondary generalization. METHODS: We conducted a retrospective multicenter survey in which a total of 376 adult patients who were newly diagnosed with MG from 2000 through 2005 were reviewed for analysis. Patients with ocular MG at the time of symptom presentation (n=202, 53.7%) were divided into two subgroups according to their prognosis: the patients whose disease remained ocular throughout the follow-ups were placed in the OMG-R group, and the patients who progressed to develop generalized disease were placed in the OMG-G group. Clinical characteristics and laboratory findings were compared between the two subgroups. RESULTS: Secondary generalization developed in 47 (23.3%) of the 202 study subjects, mostly within the first 6 months after symptom presentation, while the disease remained ocular throughout the follow-up duration (median 11.8 months) in the remaining 155 patients (76.7%). AChR antibody, abnormal repetitive nerve stimulation tests (RNST) and thymoma were more frequently observed in the patients in the OMG-G group than in those in the OMG-R group (p<0.01 in all). In seropositive cases, the titers of AChR antibody were also significantly higher in the OMG-G group than in the OMG-R group (median, 3.8 nM vs. 6.4 nM; p<0.05). Cox proportional hazards regression analyses showed that early oral prednisolone treatment significantly reduced the risk of secondary generalization (HR, 0.24; 95% CI, 0.11-0.56), whereas abnormal AChR antibody (HR, 5.34; 95% CI, 1.60-17.8) and thymoma (HR, 2.32; 95% CI, 1.21-4.45) were predictive of the development of secondary generalization. CONCLUSIONS: Our findings suggest that several factors, including the AChR antibody, thymoma, early corticosteroid treatment, and possibly latent neuromuscular abnormality revealed by RNST, may have an impact on the risk of developing generalized disease in Korean patients presenting with ocular myasthenia.
ISSN
0022-510X (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18602121

http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6T06-4SWXDNX-2-5&_cdi=4854&_user=168665&_orig=search&_coverDate=10%2F15%2F2008&_sk=997269998&view=c&wchp=dGLbVlb-zSkWz&md5=6a410edb0c8228ba8455b0b787b14634&ie=/sdarticle.pdf

http://hdl.handle.net/10371/68393
DOI
https://doi.org/10.1016/j.jns.2008.05.023
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Neurology (신경과학교실)Journal Papers (저널논문_신경과학교실)
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