The characteristics of juvenile myasthenia gravis among South Africans

Show simple item record Heckmann, J.M. Hansen, P. Van Toorn, R. Lubbe, Elsabeth (Elsa) Janse van Rensburg, Estrelita Wilmshurst, J. 2012-07-02T12:05:44Z 2012-07-02T12:05:44Z 2012-06
dc.description.abstract OBJECTIVES: To report the characteristics of juvenile-onset (<20 years) myasthenia gravis (MG) in Africa. SUBJECTS AND METHOD: Six South African centres collected data which included acetylcholine receptor-antibody (AChR-ab) status, delay before diagnosis, MG Foundation of America grade at onset, maximum severity and severity at last visit, therapies, outcomes and complications. RESULTS: We report on 190 individuals with a 4-year median follow-up (interquartile range (IQR) 1 - 8). The median age at symptom onset was 7 years (IQR 4 - 14). Ocular MG (26%) occurred among younger children (mean 5.1 years) compared with those developing generalised MG (74%) (mean 10.2 years) (p=0.0004). Remissions were obtained in 45% of generalised and 50% of ocular MG patients, of whom the majority received immunosuppressive treatment, mainly prednisone. Children with post-pubertal onset had more severe MG, but deaths were infrequent. Thymectomies were performed in 43% of those with generalised MG who suffered greater maximum disease severity (p=0.002); there was a trend towards more remissions in the thymectomy group compared with the non-thymectomy group (p=0.057). There was no racial variation with respect to AChR-ab status, maximum severity, or use of immunosuppression. However, 23% of children of African genetic ancestry developed partial or complete ophthalmoplegia as a complication of generalised MG (p=0.002). CONCLUSION: Younger children developed ocular MG and older children generalised MG. Persistent ophthalmoplegia developing as a MG complication is not uncommon among juveniles of African genetic ancestry. A successful approach to the management of this complication that causes significant morbidity is, as yet, unclear. en_US
dc.description.uri en_US
dc.identifier.citation Heckmann, JM, Hansen, P, Van Toorn, R, Lubbe, E, Janse van Rensburg, E & Wilmshurst, J 2012, 'The characteristics of juvenile myasthenia gravis among South Africans', South African Medical Journal, vol. 102, no. 6, pp. 532-536. en_US
dc.identifier.issn 0256-9574 (print)
dc.identifier.issn 2078-5135 (online)
dc.language.iso en en_US
dc.publisher Health and Medical Publishing Group en_US
dc.rights Health and Medical Publishing Group en_US
dc.subject South Africans en_US
dc.subject Juvenile myasthenia gravis en_US
dc.title The characteristics of juvenile myasthenia gravis among South Africans en_US
dc.type Article en_US

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