Dados do Trabalho

Título

CLINICAL-EPIDEMIOLOGICAL PROFILE AND FACTORS ASSOCIATED WITH PROGNOSIS IN PATIENTS WITH MYASTHENIA GRAVIS IN A REFERENCE HOSPITAL IN NORTHEASTERN BRAZIL.

Resumo

Introduction: Myasthenia gravis (MG) is an acquired chronic autoimmune, neuromuscular disorder due to autoantibodies formed against the relevant post-synaptic membrane proteins at the neuromuscular junction synapsis. According to the Myasthenia Gravis Foundation of American Clinical Classification (MGFA), the severity varies from mild weakness limited to the ocular muscles to generalized limb or axial muscles and bulbar weakness. This classification is designed to identify subgroups of patients who share distinct clinical features or severity of disease that may indicate different prognoses or responses to therapy.
Objective: This study aims to identify potential clinical predictors for the prognosis of MG, comparing groups with mild-moderate disease (MGFA I to III) and with severe disease (MGFA IV and V).
Methods: Within 88 patients followed at the Neuroimmunology Service from January 2006 to December 2021, this retrospective study included 79 patients whose medical records were available. The diagnosis of MG was based on a combination of clinical, and laboratory criteria, and electromyography.
Results: Regarding gender, 47 (59.5%) were female, corresponding to an overall female-male ratio of 1.46:1. In the clinical presentation, generalized weakness predominated (48.1%), followed by exclusively ocular symptoms, (40.5%), and less frequently by the involvement of the bulbar muscles (11.4%). As for the myasthenic crisis, 24 (20.4%) patients had at least one episode during follow-up, and for 9 of them, this was the initial clinical presentation.
When comparing the group with MGFA classification ranging from I to III, to the group in classes IV to V, it was shown that greater severity was associated with the bulbar form of MG presentation, and more frequent positivity of anti-AChR antibodies, plus the greater frequency of thymoma and thymic hyperplasia. All these associations reached statistical significance.
Conclusion: In summary, this study showed that initial presentation of the bulbar form, positivity for Anti-AChR, and association with thymic alterations are prognostic factors for MG.