The natural course of myasthenia gravis: a long term follow up study

A long term follow up study is presented of 73 patients with myasthenia gravis, living in Amsterdam between 1926 and 1965. In the period 1961-65 the annual incidence was 3.1, the prevalence 53 per million. Maximum severity of the disease occurred during the first seven years after onset in 87%. Eigh...

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Bibliographic Details
Published in:Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 1989-10, Vol.52 (10), p.1121-1127
Main Author: Oosterhuis, H J
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Antibodies - analysis
Biological and medical sciences
Child
Child, Preschool
Diseases of striated muscles. Neuromuscular diseases
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Male
Medical sciences
Middle Aged
Muscles - pathology
Myasthenia Gravis - epidemiology
Myasthenia Gravis - immunology
Myasthenia Gravis - pathology
Netherlands
Neurology
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Summary:A long term follow up study is presented of 73 patients with myasthenia gravis, living in Amsterdam between 1926 and 1965. In the period 1961-65 the annual incidence was 3.1, the prevalence 53 per million. Maximum severity of the disease occurred during the first seven years after onset in 87%. Eighteen (29%) patients died, of whom eight had a thymoma (TH). Spontaneous improvement or remission occurred at any time during the follow up. At the end of the study (1985) 16 (22%) patients were in a complete clinical remission, 13 (18%) had improved considerably (3 with prednisone), 12 (16%) had improved moderately, 12 (16%) had remained unchanged and two had deteriorated. If the early deaths are excluded the outcome is similar in the early and the late onset group without TH. Patients with TH had a less favourable course. Associated autoimmune diseases were diagnosed in 25% (n = 58). Because most of these patients were treated with anticholinesterases only, the evolution of their clinical state represents the natural course of MG.
ISSN:0022-3050
1468-330X
DOI:10.1136/jnnp.52.10.1121