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Cited 45 time in webofscience Cited 57 time in scopus
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Prognosis of ocular myasthenia in Korea: A retrospective multicenter analysis of 202 patientsopen access

Authors
Hong, Yoon-HoKwon, Seok-BeomKim, Byung-JoKim, Seung HyunKim, Jong KukPark, Kyung-SeokPark, Ki-JongSung, Jung-JoonSohn, Eun HeeLee, Yeong-BaeJeong, DushinJoo, In SooChoi, Byung-OkChoi, Young-Chul
Issue Date
Oct-2008
Publisher
ELSEVIER SCIENCE BV
Keywords
ocular myasthenia gravis; prognosis; AChR antibody; thymoma; repetitive nerve stimulation test
Citation
JOURNAL OF THE NEUROLOGICAL SCIENCES, v.273, no.1-2, pp 10 - 14
Pages
5
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF THE NEUROLOGICAL SCIENCES
Volume
273
Number
1-2
Start Page
10
End Page
14
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/16744
DOI
10.1016/j.jns.2008.05.023
ISSN
0022-510X
1878-5883
Abstract
Objectives: The aims of this study were to obtain data on the frequency with which Korean patients with autoimmune myasthenia gravis (MG) present solely with ocular disturbances and progress to develop generalized disease and to identify the prognostic factors associated with secondary generalization. Methods: We conducted a retrospective multicenter survey in which a total of 376 adult patients who were newly diagnosed with MG from 2000 through 2005 were reviewed for analysis. Patients with ocular MG at the time of symptom presentation (n=202, 53.7%) were divided into two subgroups according to their prognosis: the patients whose disease remained ocular throughout the follow-ups were placed in the OMG-R group, and the patients who progressed to develop generalized disease were placed in the OMG-G group. Clinical characteristics and laboratory findings were compared between the two subgroups. Results: Secondary generalization developed in 47 (23.3%) of the 202 study subjects, mostly within the first 6 months after symptom presentation, while the disease remained ocular throughout the follow-up duration (median 11.8 months) in the remaining 155 patients (76.7%). AChR antibody, abnormal repetitive nerve stimulation tests (RNST) and thymoma were more frequently observed in the patients in the OMG-G group than in those in the OMG-R group (p < 0.01 in all). In seropositive cases, the titers of AChR antibody were also significantly higher in the OMG-G group than in the OMG-R group (median, 3.8 nM vs. 6.4 nM; p < 0.05). Cox proportional hazards regression analyses showed that early Oral prednisolone treatment significantly reduced the risk of secondary generalization (HR, 0.24; 95% CI, 0.11-0.56), whereas abnormal AChR antibody (HR, 5.34; 95% CI, 1.60-17.8) and thymoma (HR, 2.32; 95% CI, 1.21-4.45) were predictive of the development of secondary generalization. Conclusions: Our findings suggest that several factors, including the AChR antibody, thymoma, early corticosteroid treatment, and possibly latent neuromuscular abnormality revealed by RNST, may have an impact on the risk of developing generalized disease in Korean patients presenting with ocular myasthenia. (c) 2008 Elsevier B.V. All rights reserved.
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Kim, Byung-Jo
Anam Hospital (Department of Neurology, Anam Hospital)
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