Prognostic factors for exacerbations and emergency treatments in myasthenia gravis

Single fiber EMG as a prognostic tool in myasthenia gravis

“…Therefore, the relatively high mean age at disease onset of our patient population should be considered both a representative sample and a consequence of the current epidemiology of MG. Moreover, the significant higher mean age at disease onset in group 1 ( P < 0.0032) is in accordance with some studies that have reported a more severe clinical course of MG in patients with disease onset after the fifth decade …”

Factors associated with acute exacerbations of myasthenia gravis

“…These exacerbations necessitated emergent treatment and often further hospitalization . Several studies have focused on classification of risk factors contributing to MG exacerbation necessitating emergent treatment and have identified late onset MG (above 50 years) and the presence of additional autoimmune diseases as prognostic elements . Other predisposing triggers include respiratory infection (40%), emotional stressors, microaspirations (10%), changes in medication regimen (8%), surgery, or trauma .…”

Activity limitations in myasthenia gravis and relation to clinical variables

“…A potential explanation could be that the disease course of MG itself is more severe in patients with other AID. Indeed, the presence of an additional AID is associated with a higher risk of future exacerbations and emergency treatments . However, the most likely explanation for this finding is that these AID have a negative impact on ADL independent of MG, as QMG scores between patients with additional AID and patients without additional AID did not differ significantly in our study population (mean scores were 8 and 9, respectively).…”

“…The other clinical variables included in this study were: QMG score; age; age at onset of first symptoms before or after 50 years; presence of one or more additional autoimmune disease(s) (AID); thymectomy with or without the presence of thymoma; and exacerbations or emergency treatments within the last year. These variables were chosen based on previous studies, potential clinical relevance, and reliability with which these data could be analyzed retrospectively . For the analysis of the correlation of changes in QMG and ACTIVLIM we further subdivided the QMG into an oculobulbar (first 5 items of the QMG) and a generalized domain (remaining 8 items).…”

“…An exacerbation was defined as a clinical deterioration of MG that required starting with or an increase of at least 20 mg of prednisone daily or led to an emergency treatment. An emergency treatment was defined as the administration of intravenous immunoglobulin, plasmapheresis, or mechanical ventilation …”