OCULAR MYASTHENIA GRAVIS IN A SENIOR POPULATION: DIAGNOSIS, THERAPY, AND PROGNOSIS
OCULAR MYASTHENIA GRAVIS IN A SENIOR POPULATION: DIAGNOSIS, THERAPY, AND PROGNOSIS
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DOI：
10.1002/mus.21555
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发表时间：
2010-03-01
期刊：
影响因子：
3.4
通讯作者：
Jones, H. Royden
中科院分区：
文献类型：
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作者：
Allen, Jeffrey A.;Scala, Stephanie;Jones, H. Royden
本研究的目的是（1）探讨70岁及以上（即老年人）发病的眼肌型重症肌无力（OMG）患者的预后;（2）确定该年龄组继发性全身化的预测因素;以及3）解决免疫治疗对该患者人群的影响。我们对39例70岁以后仅出现眼部体征和症状的重症肌无力患者进行了回顾性分析。泛发性重症肌无力（GMG）12例（31%）。没有GMG患者需要呼吸机辅助或喂食管。在12例进展为GMG的眼部患者中，只有1例（8%）在泛化之前接受了免疫治疗。在未进展为GMG的OMG患者中，52%接受了免疫调节治疗。我们的老年OMG患者的预后与已发表的年轻人的数据相当。虽然乙酰胆碱受体抗体滴度增加和偶尔异常重复神经刺激的存在是诊断OMG的有用工具，但没有测试可预测以后的泛化。接受免疫治疗的老年OMG患者发生GMG的频率低于未接受免疫治疗的患者。肌肉神经41：379-384，2010
The objectives of this study were (1) to explore the prognosis of ocular myasthenia gravis (OMG) in patients with onset at age 70 years and above (i.e. senior persons); (2) to identify predictors of secondary generalization in this age group; and 3) to address the effects of immunotherapy on this population of patients. We performed a retrospective analysis of 39 patients with myasthenia gravis who presented with only ocular signs and symptoms after age 70 years. Generalized myasthenia gravis (GMG) developed in 12 OMG patients (31%). None of the GMG patients required ventilator assistance or a feeding tube. Of the 12 ocular patients progressing to GMG, only one (8%) received immunotherapy prior to generalization. Of those OMG patients who did not progress to GMG, 52% received immunomodulatory therapy. Our senior OMG patients had a prognosis comparable with those of the published data for younger individuals. Although the presence of increased acetylceholine receptor antibody titers and occasionally abnormal repetitive nerve stimulation were useful tools to diagnose OMG, no test was predictive of later generalization. Senior onset OMG patients who received immunotherapy less frequently developed GMG than those not so treated. Muscle Nerve 41: 379-384, 2010