Disease severity assessment and short-term outcome in patients with myasthenia gravis

Vemuri, Deepthi; Garuda, Butchi Raju; Gopi, S.; Kumar, Tejas; Kumari, U Aruna

doi:10.4103/aian.aian_243_19

Cited by 5 publications

(5 citation statements)

References 18 publications

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“…The positivity rate of RNS is also quite variable in the literature, mainly because of the confounding factor of pyridostigmine use prior to RNS. [ 11 14 20 22 24 ] In the present study, as per HMGFA 47.3% were in remission, 21.8% Class I, 16% Class II, 11% had Class III and 3.6% had Class IV MG at the time of evaluation. Singhal BS et al .…”

Section: Discussionmentioning

confidence: 49%

“…In a recent study from southern India by Vemuri et al . [ 20 ] ocular motor weakness was the most common presentation in 74% of the patients. Ojha R et al .…”

Section: Discussionmentioning

confidence: 99%

“…Vemuri et al . [ 20 ] in their cohort of 54 patients reported a mean MGQOL15R score of 15.24. The mean scores for subjects with MGFA grade I, II, III, and IV were 5.23, 12.42, 19.67, and 27.66.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Profile and Quality of Life in Myasthenia Gravis Using MGQOL15 R(Hindi): An Indian Perspective

Majigoudra,

Duggal,

Chowdhury

et al. 2023

Annals of Indian Academy of Neurology

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Background: Myasthenia Gravis (MG) is a chronic fluctuating illness, due to the dysfunction of neuromuscular junction which is autoimmune in nature. The disease severely affects the Quality Of Life (QOL). Objective: The primary objective of our study was to assess the QOL in patients with MG using Short Form 36 (SF 36) and MGQOL 15 R (Hindi translated).The secondary objective was to assess the correlation of age, sex, illness duration, clinical characteristics, severity, and treatment with the QOL in MG patients. Methodology: A cross sectional study of 55 MG patients was done to analyse and evaluate the clinical status using Hybrid Myasthenia Gravis Foundation of America (HMGFA), Myasthenia gravis composite score (MGCS) and The Myasthenia Gravis Activities of Daily Living (MG – ADL). QOL was assessed by SF 36 and Hindi version of Myasthenia Gravis Quality of Life 15 – Revised (MG-QOL15R) score. Results: 78.2% patients had generalized MG. The mean MGC and MG-ADL scores were 5.27 and 3.29 (95% CI: 2.24 -4.34) respectively. The mean MGQOL15R score was 6.52 ± 7.7 and the score correlated with the symptoms. The SF 36 scores were the best and the worst in the bodily pain (93.72 ± 13.52) and general health subset (61.81 ± 39.64) respectively. Except for steroid dose, there was no significant correlation between SF36 and other factors. Conclusion: QOL in MG was found to be affected due to the disease. The MGQOL 15 R scores correlated with the clinical features, remission or active status, steroid use and thymectomy. No Significant association was observed between MG QOL scores and various lab parameters and repetitive nerve stimulation (RNS) test results. Higher dose of steroid was associated with poor QOL, while thymectomy was associated with better QOL scores. MGQOL15R (Hindi) is a quick and simple tool to assess the QOL in MG patients.

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Section: Discussionmentioning

confidence: 49%

“…In a recent study from southern India by Vemuri et al . [ 20 ] ocular motor weakness was the most common presentation in 74% of the patients. Ojha R et al .…”

Section: Discussionmentioning

confidence: 99%

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Clinical Profile and Quality of Life in Myasthenia Gravis Using MGQOL15 R(Hindi): An Indian Perspective

Majigoudra,

Duggal,

Chowdhury

et al. 2023

Annals of Indian Academy of Neurology

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“…In accordance, we found a wide range of ab levels in our cohort. In longitudinal studies, however, though not undebated, the dynamics of AchR-ab titer on an individual level better correlate with clinical remission [ 37 – 39 ]. In a small subgroup of our cohort the dynamics of AchR-ab titers are available that show an unequivocal fall of titers after thymectomy; enough to hypothesize that the success of thymectomy may be assessed by falling AchR-ab titers in further clinical studies.…”

Section: Discussionmentioning

confidence: 99%

The impact of thymectomy in subgroups of Myasthenia gravis patients: a single center longitudinal observation

Menghesha,

Schroeter,

Nelke

et al. 2023

Neurol. Res. Pract.

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Background Myasthenia gravis (MG) is a rare neuromuscular disorder. Symptoms can range from ptosis only to life threatening myasthenic crisis. Thymectomy is recommended for anti-acetylcholine receptor-antibody positive patients with early-onset MG. Here, we investigated prognostic factors shaping therapeutic outcomes of thymectomy to improve patient stratification. Methods We retrospectively collected single-center data from a specialized center for MG from all consecutive adult patients that underwent thymectomy from 01/2012 to 12/2020. We selected patients with thymoma-associated and non-thymomatous MG for further investigations. We analyzed the patient collective regarding perioperative parameters in relation to the surgical approach. Furthermore, we investigated the dynamics of the anti-acetylcholine receptor-antibody titers and concurrent immunosuppressive therapies, as well as the therapeutic outcomes in dependence of clinical classifications. Results Of 137 patients 94 were included for further analysis. We used a minimally invasive approach in 73 patients, whereas 21 patients underwent sternotomy. A total of 45 patients were classified as early-onset MG (EOMG), 28 as late-onset MG (LOMG) and 21 as thymoma-associated MG (TAMG). The groups differed in terms of age at diagnosis (EOMG: 31.1 ± 12.2 years; LOMG: 59.8 ± 13.7 years; TAMG: 58.6 ± 16.7 years; p < 0.001). Patients with EOMG and TAMG were more often female than patients in the LOMG group (EOMG: 75.6%; LOMG: 42.9%; TAMG: 61.9%; p = 0.018). There were no significant differences in outcome scores (quantitative MG; MG activities of daily living; MG Quality of Live) with a median follow-up of 46 months. However, Complete Stable Remission was achieved significantly more frequently in the EOMG group than in the other two groups (p = 0.031). At the same time, symptoms seem to improve similarly in all three groups (p = 0.25). Conclusion Our study confirms the benefit of thymectomy in the therapy of MG. Both, the concentration of acetylcholine receptor antibodies and the necessary dosage of cortisone therapy show a continuous regression after thymectomy in the overall cohort. Beyond EOMG, groups of LOMG and thymomatous MG responded to thymectomy as well, but therapy success was less pronounced and delayed compared to the EOMG subgroup. Thymectomy is a mainstay of MG therapy to be considered in all subgroups of MG patients investigated.

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“…Vemuri et al . [ 10 ] administered three different measures (MGQOL15, quantitative myasthenia gravis-QMG and myasthenia gravis composite score-MGC) in 54 myasthenia patients. The MGQOL15 questions were read out to the patients in local language.…”

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confidence: 99%

Utilization of Myasthenia Gravis Quality of Life Revised 15 (MGQOL15r) Scale in India

Sanghani

2023

Annals of Indian Academy of Neurology

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Disease severity assessment and short-term outcome in patients with myasthenia gravis

Cited by 5 publications

References 18 publications

Clinical Profile and Quality of Life in Myasthenia Gravis Using MGQOL15 R(Hindi): An Indian Perspective

Clinical Profile and Quality of Life in Myasthenia Gravis Using MGQOL15 R(Hindi): An Indian Perspective

The impact of thymectomy in subgroups of Myasthenia gravis patients: a single center longitudinal observation

Utilization of Myasthenia Gravis Quality of Life Revised 15 (MGQOL15r) Scale in India

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