Myasthenia gravis and risks for comorbidity

Abstract

Myasthenia gravis (MG) is an autoimmune disorder leading to skeletal muscle weakness and fatigability. MG subgroups are defined according to pathogenetic autoantibody (against acetylcholine receptor, muscle-specific tyrosine kinase or lipoprotein receptor-related protein 4), thymus pathology and clinical manifestations. MG patients have an increased risk for concordant autoimmune disease, in particular with early onset MG. Most common comorbidities are thyroid disease, systemic lupus erythematosus and rheumatoid arthritis. Cardiomyositis and subclinical heart dysfunction have been described in patients with thymoma MG and late onset MG but represent no major threat. A thymic lymphoepithelioma implies an increased risk for another cancer. Autoimmune MG represents no distinct cancer risk factor, although lymphomas and a few other cancer types have been reported with slightly increased frequency. Severe MG-related muscle weakness means a risk for respiratory failure and respiratory tract infection. Drug MG treatment can lead to side-effects. Thymectomy is regarded as a safe procedure both short and long term. Non-MG-related comorbidity represents a diagnostic and therapeutic challenge, especially in elderly patients. Diagnostic accuracy and optimal follow-up is necessary to identify and treat all types of coexisting disease in MG.

Labour market participation and sick leave among patients diagnosed with myasthenia gravis in Denmark 1997–2011: a Danish nationwide cohort study

“…work environment and health behaviour, modifying the observed associations in an unknown direction [27, 28]. Co-morbid diseases may also be a potential confounder [26, 29]. However, research shows that life expectancy in MG patients do not differ significantly from the general population which was also confirmed in our study where only minor differences in mortality were seen between MG patients and the general population [29].…”

“…Co-morbid diseases may also be a potential confounder [26, 29]. However, research shows that life expectancy in MG patients do not differ significantly from the general population which was also confirmed in our study where only minor differences in mortality were seen between MG patients and the general population [29]. This may indicate that MG patients and non-MG patients were balanced with respect to prognostic factors with heavy impact on mortality, including a range of co-morbid diseases.…”

Thymectomy in Myasthenia Gravis

“…A patient who is observed to have stabilized breathing can be shifted from the intensive care unit to the clinic room. Drains can be removed as early as possible, and discharge can be planned [46].…”

Myasthenia gravis – diagnostikk og behandling

“…Komorbiditet skal alltid klarlegges presist og vil ha betydning både for symptombilde, behandlingsrespons og behandlingsmål (13). Saerlig hos eldre med tretthet, tung pust eller nedsatt allmenntilstand kan det vaere vanskelig å avgjøre i hvilken grad symptomene skyldes hjerte-og lungesykdom, andre sykdommer eller alder.…”