アクセス数 : ?
ダウンロード数 : ?
ID 110923
タイトル別表記
高齢で発症した重症筋無力症は重症化しやすい
著者
酒井, 和香 徳島大学大学院医科学教育部(医学専攻)
Ishida, Mitsuyo Itsuki Hospital
藤田, 浩司 Tokushima University
山本, 伸昭 Tokushima University
Nishida, Yoshihiko Itsuki Hospital
三ツ井, 貴夫 Tokushima, National Hospital
キーワード
Late-onset myasthenia gravis
Elderly
Crisis
Thymectomy
Hyperplasia
Steroid
資料タイプ
学位論文
抄録
Objective: The continuous increase in the number of patients presenting with late-onset myasthenia gravis (LOMG) underscores the need for a better understanding of the clinical course and the establishment of an optimal therapeutic strategy. We aimed to clarify factors associated with clinical outcomes in LOMG.
Methods: We retrospectively reviewed the clinical profiles of 40 patients with early-onset MG (EOMG) (onset age: 49 years or younger), 30 patients with non-elderly LOMG (onset age: 50–64 years), and 28 patients with elderly LOMG(onset age: 65 years or older) and compared the subgroups according to onset age and thymus status. The evaluated parameters were MGFA classification before treatment, MG-ADL score, complicating diseases, antibody titer, treatment, and MGFA post-intervention status.
Results: Elderly LOMG patients showed transition to generalized symptoms at a higher frequency and underwent thymectomyless frequently than EOMG and non-elderly LOMG patients (p < 0.001). The frequencies of crisis and plasmapheresis were significantly lower in thymectomized LOMG patients without thymoma than in thymectomized LOMG patients with thymoma or non-thymectomized LOMG patients (p < 0.01, P < 0.05, respectively). However, the outcome was not significantly different. All of the thymectomized LOMG patients without thymoma presenting with hyperplasia or thymic cyst had a favorable clinical course.
Conclusions: Our study showed that elderly LOMG patients are more prone to severity, suggesting that they require aggressive immunomodulatory therapy.
掲載誌名
eNeurologicalSci
ISSN
24056502
出版者
Elsevier
2
開始ページ
17
終了ページ
20
発行日
2016-02-11
備考
内容要旨・審査要旨・論文本文の公開
本論文は, 著者Waka Sakaiの学位論文として提出され, 学位審査・授与の対象となっている。
権利情報
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
博士論文全文を含む
文科省報告番号
甲第3102号
学位記番号
甲医第1346号
学位授与年月日
2017-09-28
学位名
博士(医学)
学位授与機関
徳島大学
部局
病院
医学系
先端酵素学研究所