Myasthenia Gravis-Our Experience in the Last Three Years with Interesting Associations

Abstract

Background: Myasthenia gravis is a common immune mediated disease with a prevalence of 1 in 30000 populations. It is eminently treatable but when it presents atypically diagnosis can be missed. Aim: To look for the common and uncommon clinical features and antibody profile in patients with features of myasthenia gravis. Settings and design: Myasthenia gravis though well known to be associated with antibody to AchR receptor in the post synaptic membrane, a large group of patients are seronegative for AchR with atypical presentations. Anti- Titin antibody titre was done in 7 cases and anti-MUSK in 1 case when strongly indicated by clinical features. Materials and methods: 29 patients who were confirmed as Myasthenia gravis, seen by authors in the last 3 years were evaluated with anti AchR antibodies in all cases and; Anti-titin and Anti-musk antibodies when clinical indication was strong and patient could afford. Statistical analysis: Descriptive analysis was done as the number is small. Results and consideration: Maximum numbers of patients were seen in the younger age group. But patients with more serious disease, patients with Thymic and extrathymic Tumors, Anti-titin and musk associated patients were in the later age group. Thymic tumour has been not detected for nearly 10 years after disease onset in one case. Macroglossia, Motor neuron disease overlap is seen in one case which is relatively very rare. Though Myasthenia gravis is seen commonly in the young persons, Thymic and extrathymic tumors, Anti-titin antibody associated Myasthenia gravis is seen in later age group. Macroglossia and Motor neuron disease overlap features do not exclude MG.