Anti-dsDNA Is Associated with Favorable Prognosis in Myasthenia Gravis: A Retrospective Study

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Acta Neurologica Scandinavica Pub Date : 2023-03-02 DOI:10.1155/2023/8939083

Shiyin Li, Jiaxin Chen, Xu Yang, Xin Huang, Haiyan Wang, H. Feng

{"title":"Anti-dsDNA Is Associated with Favorable Prognosis in Myasthenia Gravis: A Retrospective Study","authors":"Shiyin Li, Jiaxin Chen, Xu Yang, Xin Huang, Haiyan Wang, H. Feng","doi":"10.1155/2023/8939083","DOIUrl":null,"url":null,"abstract":"Objectives. To investigate the presence of serum antinuclear antibody (ANA) and anti-double-stranded DNA antibody (anti-dsDNA) in patients with myasthenia gravis (MG) and analyze the clinical characteristics and prognostic factors associated with MG. Methods. We retrospectively enrolled 363 patients with MG and analyzed the clinical characteristics and follow-up data between patients positive and negative for ANA and anti-dsDNA. We defined a Myasthenia Gravis Activities of Daily Living (MG-ADL) reduction as a main prognosis predictor and used logistic regression to determine independent factors associated with prognosis. We built a nomogram to predict prognosis and evaluate the internal validity of the model. Results. Ninety-eight (27.0%) patients were positive for ANA, and 51 (14.0%) were positive for anti-dsDNA. Patients positive for ANA and anti-dsDNA antibodies tended to be female and positive for acetylcholine receptor antibody (AChR-Ab). The rate of thymoma was higher in anti-dsDNA-positive patients with MG (p-dsDNA-MG) than in patients negative for anti-dsDNA (49.0% vs. 26.0%, \n \n p\n =\n 0.001\n \n ), and p-dsDNA-MG was associated with reduced MG-ADL score. Regression analysis showed that except for age of onset (\n \n OR\n =\n 0.986\n \n , \n \n 95\n %\n CI\n =\n 0.973\n –\n 0.999\n \n , \n \n p\n =\n 0.037\n \n ), anti-dsDNA (\n \n OR\n =\n 2.800\n \n , \n \n 95\n %\n CI\n =\n 1.381\n –\n 5.679\n \n , \n \n p\n =\n 0.004\n \n ), ptosis (\n \n OR\n =\n 2.930\n \n , \n \n 95\n %\n CI\n =\n 1.827\n –\n 4.699\n \n , \n \n p\n <\n 0.001\n \n ), and eye movement disorder (\n \n OR\n =\n 2.815\n \n , \n \n 95\n %\n CI\n =\n 1.672\n –\n 4.741\n \n , \n \n p\n <\n 0.001\n \n ) were independent predictive factors of a favorable prognosis of MG. These predictors were used to generate a nomogram with an excellent predictive value. Conclusions. Being female and the presence of AChR-Ab were features of ANA- or anti-dsDNA-positive MG. The presence of anti-dsDNA was associated with a favorable prognosis of MG.","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Neurologica Scandinavica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2023/8939083","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives. To investigate the presence of serum antinuclear antibody (ANA) and anti-double-stranded DNA antibody (anti-dsDNA) in patients with myasthenia gravis (MG) and analyze the clinical characteristics and prognostic factors associated with MG. Methods. We retrospectively enrolled 363 patients with MG and analyzed the clinical characteristics and follow-up data between patients positive and negative for ANA and anti-dsDNA. We defined a Myasthenia Gravis Activities of Daily Living (MG-ADL) reduction as a main prognosis predictor and used logistic regression to determine independent factors associated with prognosis. We built a nomogram to predict prognosis and evaluate the internal validity of the model. Results. Ninety-eight (27.0%) patients were positive for ANA, and 51 (14.0%) were positive for anti-dsDNA. Patients positive for ANA and anti-dsDNA antibodies tended to be female and positive for acetylcholine receptor antibody (AChR-Ab). The rate of thymoma was higher in anti-dsDNA-positive patients with MG (p-dsDNA-MG) than in patients negative for anti-dsDNA (49.0% vs. 26.0%, p = 0.001 ), and p-dsDNA-MG was associated with reduced MG-ADL score. Regression analysis showed that except for age of onset ( OR = 0.986 , 95 % CI = 0.973 – 0.999 , p = 0.037 ), anti-dsDNA ( OR = 2.800 , 95 % CI = 1.381 – 5.679 , p = 0.004 ), ptosis ( OR = 2.930 , 95 % CI = 1.827 – 4.699 , p < 0.001 ), and eye movement disorder ( OR = 2.815 , 95 % CI = 1.672 – 4.741 , p < 0.001 ) were independent predictive factors of a favorable prognosis of MG. These predictors were used to generate a nomogram with an excellent predictive value. Conclusions. Being female and the presence of AChR-Ab were features of ANA- or anti-dsDNA-positive MG. The presence of anti-dsDNA was associated with a favorable prognosis of MG.

查看原文本刊更多论文

抗dsdna与重症肌无力预后良好相关的回顾性研究

目标。探讨重症肌无力（MG）患者血清抗核抗体（ANA）和抗双链DNA抗体（anti-dsDNA）的存在，分析MG的临床特点和预后因素。我们对363例MG患者进行了回顾性研究，分析了ANA和抗dsDNA阳性和阴性患者的临床特征和随访数据。我们将重症肌无力日常生活活动（MG-ADL）的减少定义为主要的预后预测因素，并使用逻辑回归来确定与预后相关的独立因素。我们建立了一个列线图来预测预后并评估模型的内部有效性。后果98名（27.0%）患者ANA阳性，51名（14.0%）患者抗dsDNA阳性。ANA和抗dsDNA抗体阳性的患者往往是女性，乙酰胆碱受体抗体（AChR-Ab）阳性。抗dsDNA阳性MG患者（p-dsDNA-MG）的胸腺瘤发生率高于抗dsDNA阴性患者（49.0%对26.0%，p=0.001），且p-dsDNA-M G与MG-ADL评分降低有关。回归分析显示，除发病年龄（OR=0.986，95%CI=0.973–0.999，p=0.037）、抗dsDNA（OR=2.800，95%CI=1.381–5.679，p=0.004）、上睑下垂（OR=2.930，95%CI=1.827–4.699，p<0.001）外，和眼球运动障碍（OR=2.815，95%CI=1.672–4.741，p<0.001）是MG良好预后的独立预测因素。这些预测因素用于生成具有良好预测价值的列线图。结论。女性和AChR-Ab的存在是ANA或抗dsDNA阳性MG的特征。抗dsDNA的存在与MG的良好预后有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Acta Neurologica Scandinavica 医学-临床神经学

CiteScore

6.70

自引率

2.90%

发文量

161

审稿时长

4-8 weeks

期刊介绍： Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.