Incidence and clinical feature of Myasthenia gravis: A five-year data analysis in Ulaanbaatar, Mongolia
DOI:
https://doi.org/10.31117/neuroscirn.v4i3Suppl.96Keywords:
Myasthenia gravis, incidence, gender distribution, Early onset myasthenia gravis, Late onset myasthenia gravisAbstract
Myasthenia gravis (MG) is a rare neuromuscular disorder. Till now, there are no studies on the prevalence and incidence of MG in Mongolia. The current study aimed to elucidate the incidence of MG in Ulaanbaatar, the age of onset, and the gender distribution of Mongolian patients with MG. We conducted a cross-sectional, hospital-based study involving MG patients (n=48) all around Ulaanbaatar from 1 January 2015 to 1 January 2020. The clinical diagnosis was assessed with the Myasthenia Gravis Foundation of America (MGFA) classification system. The disease severity was evaluated by using Osserman’s classification. The diagnosis was confirmed with serological and electrophysiological tests. Statistical analysis was performed using SPSS software. A total of 30 patients with MG were registered for the last five years in Ulaanbaatar. The average annual incidence of MG in Ulaanbaatar was 0.65 per 100,000 populations (95%CI 0.26-1.34), 0.60 in males (95%CI 0.25-1.28), and 0.69 in females (95%CI 0.33-1.46). The cumulative incidence in the study period was 3.2 per 100,000 populations. The ratio of males to females was 1:1,3. The median age for onset of MG was 33 years (ranging from 27 to 46 years); 43.3% of patients had ocular and 56.7% generalized symptoms at the disease onset. Only 23.3% of patients remained with purely ocular symptoms (Osserman I stage). The average incidence of MG between 2015 and 2020 was 6,5 per 1.000.000 population, and the annual incidence was relatively stable. Although ocular and generalized symptoms were observed each in about half of the cases, only one-fourth remained with pure ocular signs at the end of the review period.
References
Aarli J.A. (1999). Late-onset myasthenia gravis: a changing scene. Archives of Neurology, 56(1), 25–27. https://doi.org/10.1001/ARCHNEUR.56.1.25
Alshekhlee, A., Miles, J. D., Katirji, B., Preston, D. C., & Kaminski, H. J. (2009). Incidence and mortality rates of myasthenia gravis and myasthenic crisis in US hospitals. Neurology, 72(18), 1548–1554. https://doi.org/10.1212/WNL.0B013E3181A41211
Bever Jr, C. T., Aquino, A. V., Penn, A. S., Lovelace, R. E., & Rowland, L. P. (1983). Prognosis of ocular Myasthenia. Annals of Neurology, 14(5), 516–519. https://doi.org/10.1002/ANA.410140504
Boldingh, M. I., Maniaol, A. H., Brunborg, C., Dekker, L., Heldal, A. T., Lipka, A. F., Popperud, T. H., Niks, E. H., Verschuuren, J. J. G. M., & Tallaksen, C. M. E. (2015). Geographical distribution of myasthenia gravis in northern europe - results from a population-based study from two countries. Neuroepidemiology, 44(4), 221–231. https://doi.org/10.1159/000431036
Carr, A. S., Cardwell, C. R., McCarron, P. O., & McConville, J. (2010). A systematic review of population based epidemiological studies in Myasthenia Gravis. BMC Neurology, 10. https://doi.org/10.1186/1471-2377-10-46
Casetta, I., Groppo, E., De Gennaro, R., Cesnik, E., Piccolo, L., Volpato, S., & Granieri, E. (2010). Myasthenia gravis: a changing pattern of incidence. Journal of Neurology, 257(12), 2015–2019. https://doi.org/10.1007/S00415-010-5651-Z
Chen, J., Tian, D. C., Zhang, C., Li, Z., Zhai, Y., Xiu, Y., Gu, H., Li, H., Wang, Y., & Shi, F. D. (2020). Incidence, mortality, and economic burden of myasthenia gravis in China: A nationwide population-based study. The Lancet Regional Health. Western Pacific, 5, 100063. https://doi.org/10.1016/J.LANWPC.2020.100063
Ding, J., Zhao, S., Ren, K., Dang, D., Li, H., Wu, F., Zhang, M., Li, Z., & Guo, J. (2020). Prediction of generalization of ocular myasthenia gravis under immunosuppressive therapy in Northwest China. BMC Neurology, 20(1), 1–8. https://doi.org/10.1186/S12883-020-01805-1
Gilhus N.E., Nacu A., Andersen J.B., & Owe J.F. (2015). Myasthenia gravis and risks for comorbidity. European Journal of Neurology, 22(1), 17–23. https://doi.org/10.1111/ENE.12599
Jaretzki, A., Barohn, R. J., Ernstoff, R. M., Kaminski, H. J., Keesey, J. C., Penn, A. S., & Sanders, D. B. (2000). Myasthenia gravis: recommendations for clinical research standards. Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of America. Neurology, 55(1), 16–23. https://doi.org/10.1212/WNL.55.1.16
Kupersmith, M. J., Latkany, R., & Homel, P. (2003). Development of generalized disease at 2 years in patients with ocular myasthenia gravis. Archives of Neurology, 60(2), 243–248. https://doi.org/10.1001/ARCHNEUR.60.2.243
Lavrnić, D., Jarebinski, M., Rakočević-Stojanović, V., Stević, Z., Lavrnić, S., Pavlović, S., Trikić, R., Tripković, I., Nešković, V., & Apostolski, S. (1999). Epidemiological and clinical characteristics of myasthenia gravis in Belgrade, Yugoslavia (1983–1992). Acta Neurologica Scandinavica, 100(3), 168–174. https://doi.org/10.1111/J.1600-0404.1999.TB00733.X
Lee, H. S., Lee, H. S., Shin, H. Y., Choi, Y. C., & Kim, S. M. (2016). The Epidemiology of Myasthenia Gravis in Korea. Yonsei Medical Journal, 57(2), 419–425. https://doi.org/10.3349/YMJ.2016.57.2.419
Lee, I., Kaminski, H. J., Xin, H., & Cutter, G. (2018). Gender and quality of life in myasthenia gravis patients from the myasthenia gravis foundation of America registry. Muscle & Nerve, 58(1), 90–98. https://doi.org/10.1002/MUS.26104
Leeamornsiri, S., Chirapapaisan, N., & Chuenkongkaew, W. (2011). Clinical profiles of thai patients with ocular myasthenia gravis in siriraj hospital. Journal of the Medical Association of Thailand, 94(9), 1117-1121.
Mantegazza, R., Baggi, F., Antozzi, C., Confalonieri, P., Morandi, L., Bernasconi, P., Andreetta, F., Simoncini, O., Campanella, A., Beghi, E., & Cornelio, F. (2003). Myasthenia gravis (MG): epidemiological data and prognostic factors. Annals of the New York Academy of Sciences, 998, 413–423. https://doi.org/10.1196/ANNALS.1254.054
Matsuda, M., Dohi-Iijima, N., Nakamura, A., Sekijima, Y., Morita, H., Matsuzawa, S., Sato, S. I., Yahikozawa, H., Tabata, K. I., Yanagawa, S., & Ikeda, S. I. (2005). Increase in incidence of elderly-onset patients with myasthenia gravis in Nagano Prefecture, Japan. Internal Medicine, 44(6), 572–577. https://doi.org/10.2169/INTERNALMEDICINE.44.572
Matsui, N., Nakane, S., Nakagawa, Y., Kondo, K., Mitsui, T., Matsumoto, T., Arisawa, K., & Kaji, R. (2009). Increasing incidence of elderly onset patients with myasthenia gravis in a local area of Japan. Journal of Neurology, Neurosurgery, and Psychiatry, 80(10), 1168–1171. https://doi.org/10.1136/JNNP.2008.152637
Murai, H., Yamashita, N., Watanabe, M., Nomura, Y., Motomura, M., Yoshikawa, H., Nakamura, Y., Kawaguchi, N., Onodera, H., Araga, S., Isobe, S., Nagai, M., & Kira, J. (2011). Characteristics of myasthenia gravis according to onset-age: Japanese nationwide survey. Journal of the Neurological Sciences, 305(1–2), 97–102. https://doi.org/10.1016/J.JNS.2011.03.004
Pakzad Z., Aziz T., & Oger J. (2011). Increasing incidence of myasthenia gravis among elderly in British Columbia, Canada. Neurology, 76(17), 1526–1528. https://doi.org/10.1212/WNL.0B013E318217E735
Poulas, K., Tsibri, E., Kokla, A., Papanastasiou, D., Tsouloufis, T., Marinou, M., Tsantili, P., Papapetropoulos, T., & Tzartos, S. (2001). Epidemiology of seropositive myasthenia gravis in Greece. Journal of Neurology, Neurosurgery, and Psychiatry, 71(3), 352. https://doi.org/10.1136/JNNP.71.3.352
Oparah, S.K., & Ibanga, A.A. (2020). Myasthenia Gravis at Presentation: A 14 Year Instituti 3(3), 22-28 onal Review of a Rare Disorder in Calabar, Southern Nigeria. Asian Journal of Medical Principles and Clinical Practice, 3(3), 22–28 https://www.journalajmpcp.com/index.php/AJMPCP/article/view/30120
Singhal, Bhatia, N. S., Umesh, T., & Menon, S. (2008). Myasthenia gravis: A study from India. Neurology India, 56(3), 352. https://doi.org/10.4103/0028-3886.43455
Turner, C. (2007). A review of myasthenia gravis: Pathogenesis, clinical features and treatment. Current Anaesthesia and Critical Care, 18(1), 15–23. https://doi.org/10.1016/J.CACC.2007.01.006
Vincent, A. (2008). Autoimmune disorders of the neuromuscular junction. Neurology India, 56(3), 305. https://doi.org/10.4103/0028-3886.43449
Wing, Lok., Mrcp, A. U., Das, A., Fams, A., Tjia, H. T., & Fams, M. (2003). Myasthenia gravis in Singapore. Neurology Asia, 8, 35-40. http://www.neurology-asia.org/articles/20031_035.pdf
Yu, Y. L., Hawkins, B. R., Ip, M. S., Wong, V., & Woo, E. (1992). Myasthenia gravis in Hong Kong Chinese. 1. Epidemiology and adult disease. Acta Neurologica Scandinavica, 86(2), 113–119. https://doi.org/10.1111/J.1600-0404.1992.TB05050.X
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2021 Oyunaa Chimedregzen, Sarangerel Jambal, Munkhbayar Rentsenbat, Byambasuren Dagvajantsan
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The observations and associated materials published or posted by NeurosciRN are licensed by the authors for use and distribution in accord with the Creative Commons Attribution license CC BY-NC 4.0 international, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
