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• W605647230 abstract "Myasthenia gravis (MG) is an autoimmune neuromuscular disorder characterised by a fluctuant variable weakness. In 90% of cases antibodies against the nicotinic acetylcholine receptor (AchRAb) are pathogenetic: they reduce acetylcholine receptors (AChR) number and impair their function at the neuromuscular endplate. The main feature is a variable weakness of the skeletal muscles that may involve different muscle districts (ocular, bulbar, limbs). Symptoms are worse in the evening or after prolonged exercise and can be reduced by rest. The diagnosis is based on a detailed clinical history, on pharmacological tests and measurement of AchR-Ab. To evaluate the clinical features, the diagnosis and the therapeutic response in 297 myasthenic patients collected in our Neuromuscular Centre Database. Knowledge of the prognostic factors may help to understand the course of MG and optimize its management.We carried out a study in 297 MG patients followed at the Clinical Centre for Neuromuscular diseases of Padua and of Santa Chiara Hospital, in Trento. In a database we collected general and demographic information, diagnostic tests, clinical data about onset, age and type of thymectomy, therapy and clinical status at the last follow-up visit. For all the measured parameters the Myasthenia Gravis Foundation of America (MGFA) classification has been used. Finally we did a statistic analysis.We consider 177 females and 120 males. The mean age at onset was 47 ± 20 years and it results significantly inferior in female respect male (p < 0.00001). The late onset group was the largest (28%). Thymectomy was performed in 52% of patients. The mean time of follow-up was 9 ± 8.6 years; 40% had relapses during the disease; the presence of relapses results significantly associated to MG class. At last visit 64.9% of patients were improved: 10.4% in remission. We find a significant association between clinical improvement and MG class (p = 0.001), MGFA score at onset (p = 0.00004) and thymectomy (p = 0.005). In 71.1% of cases the diagnosis was made at the onset of the disease; in the other patients there is an average diagnostic delay of 2.6 ± 3.8 years. The age at onset wasn't significant associated to outcome; the delay results significantly associated to MG class (Kruskal Wallis p = 0.02) and to clinical outocme (Kruskal Wallis p = 0.03).We analysed a large series of patients from 2 differents hospitals, and we consider disease aspects. From ours studies it results that clinical outcomes depends on MG class, on thymectomy, use of immunomodulant therapy and diagnostic delay. Sex, age at onset and presence of other autoimmune disease don't seem to be significantly associated to outcome." @default.
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• W605647230 date "2011-10-01" @default.
• W605647230 modified "2023-09-23" @default.
• W605647230 title "P-1Prognostic factors and course of myastheniagravis" @default.
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