Role of Myasthenia Gravis Auto-Antibodies as Predictor of Myasthenic Crisis and Clinical Parameters

Abstract

Background: Myasthenia Gravis (MG) is an autoimmune disease of the neuromuscular junction. Like any other autoimmune disorder, it can flare up owing to certain predisposing factors, causing severe symptoms, named myasthenia crisis. Aim: The aim of this study is to ascertain any relation of variability of Myasthenia auto-antibodies to myasthenia clinical features especially crisis. Methods: It is a cross sectional study, carried out in Rashid Hospital, Dubai. MG patients between 2004-2010 were recruited and followed for minimum 5 years period. Relationship between disease severity, diversity, immunology and other variables was made through chisquare test mainly. Result: A total of 143 patients were included in the study and 102 completed the follow up. Females predominated in number and their onset was relatively earlier than males (p<0.001). Total 58.8% of patients (67% AchR-Ab+ patients, all MuSK-Ab+ and 33% of seronegative) experienced crisis. Seropositive patients had 30% more tendency to develop crisis (p<0.05). Moreover, myasthenia crisis directly proportional to disease severity at presentation. Conclusion: Seropositive MG is severe form of MG and further in this group MuSK-Ab MG showed higher MGFA grading at presentation and more frequent MG crisis. seronegative patients develop crisis at relatively late age. Seropositivity, mechanical ventilation, old age and high starting MGFA grade indicated poor outcome after crisis.