Abstract
Objectives:To investigate the clinical features of patients with myasthenia gravis complicated with and without hyperthyroidism.Methods:A total of 2083 patients with myasthenia gravis (MG) admitted in Center of Treatment of Myasthenia Gravis Hebei Province between January 2013 and July 2020 were retrospectively analyzed and divided into two groups: Group-A and Group-B, with 108 MG patients complicated with hyperthyroidism in Group-A and 1975 MG patients without thyroid disease in Group-B. The age of onset, gender, Osserman classification, acetylcholine receptor antibody and thymus status of the two groups were analyzed in the two groups. Independent-sample t test was used for intra-group comparison, and χ2 test was utilized for comparison of enumeration data. P<0.05 indicates a statistically significant difference.Results:The age of onset in Group-A was significantly lower than that in Group-B (p=0.000), the number of female patients was significantly higher than that in Group-B (p=0.037), and the level of Achrabs titer was significantly lower than that in Group-B (p=0.000). The incidence of thymoma in Group-A was significantly lower than that in Group-B (p=0.012), while the incidence of thymic hyperplasia was significantly higher than that in Group-B (p=0.000).Conclusion:Patients with MG complicated with hyperthyroidism are mainly female, with a lower age of onset, a lower level of acetylcholine receptor antibody, a lower incidence of thymoma, and a higher incidence of thymic hyperplasia. The clinical features of such patients are remarkably different from those of MG without thyroid disease.
Highlights
Myasthenia gravis (MG), as an autoimmune disease involving the postsynaptic membrane of the neuromuscular junction, is often accompanied by a variety of autoimmune diseases
Thyroid disease autoimmune diseases in myasthenia gravis (MG) patients are mainly divided into three types: hyperthyroidism, hypothyroidism, and positive anti-thyroid antibodies[2], among which hyperthyroidism is most frequently mentioned, which may have a close bearing on its high incidence and obvious clinical symptoms
The incidence of thyroid disease among patients admitted to our center was 13.8% (315/2290), of which the incidence of patients with hyperthyroidism was 4.7% (n=108).Sixty-six females and 42 males were assigned to Group-A, while 1003 females and 972 males were assigned to Group B (1.6:1 vs 1.03:1, p=0.037)
Summary
Myasthenia gravis (MG), as an autoimmune disease involving the postsynaptic membrane of the neuromuscular junction, is often accompanied by a variety of autoimmune diseases. MG and thyroid diseases are both antibody-mediated diseases, which are organ specific, and can be manifested as abnormal ocular muscles. This may be related to the fact that both of them share a common genetic background.[3] It has been shown in previous studies that the incidence of ocular MG is higher in cases of abnormal thyroid autoimmunity.[4] the prevalence of thyroid disease varies from study to study, and it is not yet known whether the clinical features and course of disease in these patients are different from those in patients without hyperthyroidism. The prevalence, age, gender, Osserman type, acetylcholine receptor antibody level and thymus condition of MG patients with hyperthyroidism in our center were evaluated and analyzed
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