Background:

Myasthenia gravis (MG) is a post-synaptic autoimmune disease of the neuromuscular junction, whose cardinal manifestations are weakness and fatigue.

Objective:

The objective of the study was to report a cohort of patients with a diagnosis of MG in a West Mexican hospital and compare the clinical profile, diagnostic, and therapeutic approach and prognosis against a previously published cohort of the same hospital.

Materials and methods:

Consecutive patients included in two cohorts: the first one already published from 1999 to 2007 and the second one reported here from 2008 to 2018.

Results:

The most recent cohort included 39 patients, 23 women (59%), with an average age of 50 years, and superior to the previous cohort (43 years). Hypertension (39%) and diabetes (18%) were observed with a marked increase in the current cohort. The distribution in the Osserman staging was very similar. The positivity of acetylcholine receptor antibodies (ACRA) increased from 37% to 88%. In both cohorts, most patients received pyridostigmine and in two-thirds steroids. The previous cohort recorded 4% of patients treated with a steroid-sparing immunosuppressant, contrasting with 90% (azathioprine 85%, and mycophenolate 5%) of the current cohort. Thymectomy was a less frequent practice in 12%. Mortality showed a significant decrease from 16% to 0%.

Conclusion:

Differences were observed among the cohorts, highlighting in the most recent one a higher age, the appearance of chronic-degenerative diseases, greater positivity to ACRA, optimization of pharmacological management, less thymectomy, and no mortality. Replicas of this work in other hospital settings are pertinent.

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