Clinical Neurology and Neurosurgery
Volume 109, Issue 8 , Pages 686-691 , October 2007

Nonthymoma early-onset- and late-onset-generalized myasthenia gravis—A retrospective hospital-based study

  • K.H. Chan

      Affiliations

    • Corresponding Author InformationCorresponding author at: University Department of Medicine, 4/F Professorial Block, Queen Mary Hospital, Pokfulam Road, Hong Kong, China. Tel.: +852 2855 5318; fax: +852 2855 5322.
  • ,
  • R.T.F. Cheung
  • ,
  • W. Mak
  • ,
  • S.L. Ho

Received 2 March 2007 ,Revised 28 May 2007 ,Accepted 30 May 2007.

References 

  1. Drachman DB. Myasthenia gravis [review]. N Eng J Med. 1994;330:1797–1810
  2. Hoch W, McConville J, Helms S, Newsom-Davis J, Melms A, Vincent A. Auto-antibodies to the receptor tyrosine kinase MuSK in patients with myasthenia gravis without acetylcholine receptor antibodies. Nat Med. 2001;7:365–368
  3. Scuderi F, Marino M, Colonna L, Mannella F, Evoli A, Provenazano C, et al. Anti-p110 autoantibodies identify a subtype of “seronegative” myasthenia gravis with prominent oculobulbar involvement. Lab Invest. 2002;82(9):1139–1146
  4. Evoli A, Ronali PA, Padua L, Monaco ML, Scuderi F, Batocchi AP, et al. Clinical correlates with anti-MuSK antibodies in generalized seronegative myasthenia gravis. Brain. 2003;126:1–8
  5. Shigemoto K, Kubo S, Maruyama N, Hato N, Yamada H, Jie C, et al. Induction of myasthenia by immunization against muscle-specific kinase. J Clin Invest. 2006;116(4):1016–1024
  6. Vincent A, Leite MI. Neuromuscular junction autoimmune disease: muscle specific kinase antibodies and treatments of myasthenia gravis. Curr Opin Neurol. 2005;18:519–525
  7. Lennon VA. Serological profile of myasthenia gravis and distinction from the Lambert–Eaton myasthenic syndrome. Neurology. 1997;48(Suppl 5):S23–S27
  8. Williams CL, Hay JE, Huiatt TW, Lennon VA. Paraneoplastic IgG striational autoantibodies produced by clonal thymic B-cells and in serum of patients with myasthenia gravis and thymoma react with titin. Lab Invest. 1992;66:331–336
  9. Somnier FE, Engel PJ. The occurrence of anti-titin antibodies and thymomas: a population survey of MG 1970–1999. Neurology. 2002;59(1):92–98
  10. Ohta M, Ohta K, Itoh N, Kurobe M, Hayashi K, Nishitani H. Anti-skeletal muscle antibodies in the sera of patients with thymoma: identification of anti-myosin, actomyosin, actin and alpha-actinin antibodies by a solid-phase radioimmunoassay and Western blotting analysis. Clin Chim Acta. 1990;187:255–264
  11. Yamamoto AM, Gaidos P, Eymard B, Tranchant C, Warter JM, Gomez L, et al. Anti-titin antibodies in myasthenia gravis. Arch Neurol. 2001;58:885–890
  12. Romi F, Skeie GO, Vedeler C, Aarli JA, Zorzato F, Gilhus NE. Complement activation by titin and ryanodine receptor autoantibodies in myasthenia gravis: a study of IgG subclasses and clinical correlations. J Neuroimmunol. 2000;111:169–176
  13. Romi F, Skeie GO, Aarli A, Gilhus E. The severity of myasthenia gravis correlates with the serum oncentration of titin and ryanodine receptor antibodies. Arch Neurol. 2000;57:1596–1600
  14. Skeie GO, Mygland A, Aarli JA, Gilhus NE. Titin antibodies in patients with late onset myasthenia gravis: clinical correlations. Autoimmunity. 1995;20:99–104
  15. Skeie GO, Bartoccioni E, Evoli A, Romi F, Gilhus NE, Aarli JA. Ryanodine receptor antibodies are associated with severe myasthenia gravis. Eur J Neurol. 1996;3:136–140
  16. Somnier FE, Skeie GO, Aarli JA, Trojaborg W. EMG evidence of myopathy and the occurrence of titin autoantibodies in patients with myasthenia gravis. Eur J Neurol. 1999;6:1–9
  17. Aarli JA. Inflammatory myopathy in myasthenia gravis. Curr Opin Neurol. 1998;11:233–234
  18. Keesey JC. Clinical evaluation and management of myasthenia gravis. Muscle Nerve. 2004;29:484–505
  19. Aarli JA. Late onset myasthenia gravis. Eur J Neurol. 1997;4:203–205
  20. Somnier FE. Increasing incidence of late-onset anti-AChR antibody-seropositive myasthenia gravis. Neurology. 2005;65(6):928–930
  21. Vincent A, Clover L, Buckley C, Evans JG, Rothwell PM. Evidence of underdiagnosis of myasthenia gravis in older people. J Neurol Neurosurg Psychiatry. 2003;74(8):1105–1108
  22. Griesmann GE, Lennon VA. Detection of autoantibodies in myasthenia gravis and Lambert–Eaton myasthenic syndrome. In:  Rose NR,  De Macario EC,  Folds JD,  Lane HC,  Nakamura RM editor. Manual of clinical and laboratory immunology. 5th ed.. Washington, DC: ASM Press; 1997;p. 983–988
  23. Slater G, Papetestas AE, Genkins G, Kornfeld P, Horowitz SH. Thymectomy in patients more than 40 years of age with myasthenia gravis. Surg Gynecol Obstet. 1978;146:54–56
  24. Frist WH, Thirumalai S, Doehring CB, Merrill WH, Stewart JR, Fenichel GM, et al. Thymectomy for the myasthenia gravis patient. Ann Thorac Surg. 1994;57:334–338
  25. de Perrot M, Licker M, Spiliopoulos A. Factors influencing improvement and remission rates after thymectomy for myasthenia gravis. Respiration. 2001;68(6):601–605
  26. Gronseth GS, Barohn RJ. Practive parameters: thymectomy for autoimmune myasthenia gravis (an evidence-based review): report of the Quality Standard Subcommittee of the American Academy of Neurology. Neurology. 2000;55:7–15
  27. Donaldson DH, Ansher M, Horan S, Rutherford RB, Ringel SP. The relationship of age to outcome in myasthenia gravis. Neurology. 1990;40:786–790
  28. Kapinas K, Kimiskidis VK, Kazis AD, Kokkas B, Tsolaki M, Georgiadis G. Myasthenia gravis: correlation of age with clinical course and anti-AchR antibody levels. Int J Immunopathol Pharmacol. 1999;12:127–131
  29. Slesak G, Melms A, Gerneth F, Sommer N, Weissert R, Dichgans J. Late-onset myasthenia gravis: follow-up of 113 patients diagnosed after age 60. Ann NY Acad Sci. 1998;841:777–780
  30. Yu YL, Hawkins BR, Ip MS, Wong V, Woo E. Myasthenia gravis in Hong Kong Chinese. 1. Epidemiology and adult disease. Acta Neurol Scand. 1992;86:113–119
  31. Chen WH, Chiu HC, Hseih RP. Association of HLA-Bw46DR9 combination with juvenile myasthenia gravis in Chinese. J Neurol Neurosurg Psychiatry. 1993;56:382–385
  32. Hawkins BR, Chan-Lui WY, Choi EKK, Ho AY. Strong association of HLA BW46 with juvenile onset myasthenia gravis in Hong Kong Chinese. J Neurol Neurosurg Psychiatry. 1984;47:555–557
  33. Yeh JH, Chen WH, Chiu HC, Vincent A. Low frequency of MuSK antibody in generalized seronegative myasthenia gravis among Chinese. Neurology. 2004;62:2131
  34. Tackenberg B, Nitschke M, Wilcox N, Ziegler A, Nessler S, Schumm F, et al. CD45 isoform expression in autoimmune myasthenia gravis. Autoimmunity. 2003;36(2):117–121

PII: S0303-8467(07)00158-8

doi: 10.1016/j.clineuro.2007.05.023

Clinical Neurology and Neurosurgery
Volume 109, Issue 8 , Pages 686-691 , October 2007