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Course And Prognosis Of Myasthenia Gravis: A Systematic Review

Z.-F. Mao, X.-A. Mo, C. Qin, Y-R Lai, T. olde Hartman
Published 2010 · Medicine

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The clinical course of myasthenia gravis (MG) is variable, and spontaneous remission is still uncommon. Knowledge of the prognostic factors may help understand the course of MG and thus optimize its management. A systematic review search was conducted in MEDLINE and EMBASE for English language studies from 1985 through 2009. We identified additional studies by reviewing bibliographies of retrieved articles and hand search main journal of neurology. Studies evaluating variables associated with or predictive of remission in adult patients with MG were included. Because of methodological heterogeneity, we refrained from statistical pooling, instead, a best evidence synthesis was used for summarizing the results. From 1810 potentially relevant studies, 13 cohort studies met the inclusion criteria. The included studies were heterogeneous considerably in sample size, disease duration, follow‐up years, definition of remission, and analysis. Study quality was limited by retrospective design in most studies and lack of multivariate analysis. Time of diagnosis from onset (<1 year) showed strong evidence of predicting a better remission. In studies using completely stable remission outcomes, there was strong evidence that age at onset (<40 years) was of prognostic importance. Furthermore, gender showed no association with remission. Time of diagnosis from onset and age at onset were found to be predictors of remission. Gender does not seem to predict the course of MG. Our findings should be interpreted with caution because of the clinical and methodological heterogeneity of included studies.
This paper references
10.5271/SJWEH.504
Physical risk factors for neck pain.
G. Ariëns (2000)
10.1111/j.1468-1331.2005.01137.x
Seronegative myasthenia gravis: disease severity and prognosis
F. Romi (2005)
10.1002/SIM.1180
Kappa coefficients in medical research.
Helena Chmura Kraemer (2002)
10.1001/ARCHNEUR.56.1.25
Late-onset myasthenia gravis: a changing scene.
J. Aarli (1999)
10.1002/mus.20950
Lifetime course of myasthenia gravis
D. Grob (2008)
Evaluation of the quality of prognosis studies in systematic reviews
JA Hayden (2006)
10.1002/mus.20921
Single‐fiber electromyography of masseter muscle in myasthenia gravis
A. Khuraibet (2008)
10.1177/205873929901200303
Myasthenia gravis: correlation of age with clinical course and anti-AChr antibody levels.
K. Kapinas (1999)
10.1002/mus.21016
Disease‐specific measure of quality of life for myasthenia gravis
L. Mullins (2008)
10.3310/HTA11500
Evaluation of diagnostic tests when there is no gold standard. A review of methods.
A. Rutjes (2007)
10.1016/0022-510X(91)90260-E
Prognosis of myasthenia gravis: A multicenter follow-up study of 844 patients
E. Beghi (1991)
10.1136/bmj.323.7306.224
Systematic reviews of evaluations of prognostic variables
D. Altman (2001)
10.1212/WNL.47.5.1233
Epidemiologic evidence for a changing natural history of myasthenia gravis
L. H. Phillips (1996)
10.1016/S0003-4975(00)01595-2
Myasthenia gravis: recommendations for clinical research standards1
A. Jaretzki (2000)
10.1212/WNL.55.1.16
Myasthenia gravis
A. Jaretzki (2000)
10.1111/j.1478-3231.2008.01957.x
Prognostic indicators in hepatocellular carcinoma: a systematic review of 72 studies
P. Tandon (2009)
10.7326/0003-4819-144-6-200603210-00010
Evaluation of the Quality of Prognosis Studies in Systematic Reviews
J. Hayden (2006)
10.1007/BF00315656
A multicentre follow-up study of 1152 patients with myasthenia gravis in Italy
R. Mantegazza (2004)
Perspectives on prognosis of soft tissue musculoskeletal disorders
P. Hudak (1998)
10.1212/WNL.40.5.786
The relationship of age to outcome in myasthenia gravis
D. Donaldson (1990)
10.1007/S001150050250
[Follow-up of myasthenia gravis. Results of a longitudinal study of the significance of psychosocial predictors].
J. Knieling (1998)
10.1001/ARCHNEUR.1991.00530190081019
Epidemiology of myasthenia gravis in Denmark. A longitudinal and comprehensive population survey.
F. Somnier (1991)
10.1016/j.jns.2008.05.023
Prognosis of ocular myasthenia in Korea: A retrospective multicenter analysis of 202 patients
Y. Hong (2008)
10.1007/s004150050059
Myasthenia gravis: diagnosis and follow-up of 100 consecutive patients
R. Beekman (1997)
Follow-up of myasthenia gravis
J Knieling
10.1007/s004150050142
Prognosis of myasthenia gravis: a retrospective study of 380 patients
V. Cosi (1997)
Lifetime course of myasthenia gravis. Muscle Nerve
D Grob (2008)
10.1053/j.ajkd.2008.03.005
Recovery of kidney function after acute kidney injury in the elderly: a systematic review and meta-analysis.
R. Schmitt (2008)
10.1016/j.clineuro.2007.05.023
Nonthymoma early-onset- and late-onset-generalized myasthenia gravis—A retrospective hospital-based study
K. Chan (2007)
2nd. The epidemiology of myasthenia gravis
LH Phillips (2003)
10.1196/annals.1254.055
Myasthenia Gravis in Individuals over 40
J. Aarli (2003)
Causes of death among patients with myasthenia gravis in Norway between
JF Owe (1951)
10.1016/S0387-7604(12)80092-1
Factors influencing the clinical type and course of myasthenia gravis
M. Hayashi (1992)
10.1007/s001150050250
Krankheitsverlauf bei Myasthenia gravis Ergebnisse einer Längsschnittstudie zur Bedeutung psychosozialer Prädiktoren
J. Knieling (1998)
10.5144/0256-4947.2008.341
Myasthenia gravis: presentation and outcome in 104 patients managed in a single institution
Mansour A. Al-Moallem (2008)
10.1001/ARCHNEUR.64.8.1121
Classification of myasthenia gravis based on autoantibody status.
S. Suzuki (2007)
10.1196/annals.1254.053
The Epidemiology of Myasthenia Gravis
L. H. Phillips (1994)
10.1212/WNL.63.6.1138-a
Treatment of autoimmune myasthenia gravis
Andrew Bragdon (2004)
10.1136/bmj.38748.697465.55
Factors predisposing women to chronic pelvic pain: systematic review
P. Latthe (2006)
10.1136/jnnp.52.10.1121
The natural course of myasthenia gravis: a long term follow up study.
H. Oosterhuis (1989)
10.1196/annals.1254.054
Myasthenia Gravis (MG): Epidemiological Data and Prognostic Factors
R. Mantegazza (2003)
10.1097/00004356-199803000-00003
Perspectives on prognosis of soft tissue musculoskeletal disorders.
Hudak Pl (1998)
10.1136/jnnp.2005.072355
Causes of death among patients with myasthenia gravis in Norway between 1951 and 2001
J. F. Owe (2006)
Causes of death among patients with myasthenia gravis in Norway between 1951 and
J F Owe (2001)
10.1136/jnnp.2006.109488
Myasthenia gravis: a long term follow-up study of Swedish patients with specific reference to thymic histology
N. Tsinzerling (2007)
10.1196/annals.1405.014
Status of the Thymectomy Trial for Nonthymomatous Myasthenia Gravis Patients Receiving Prednisone
J. Newsom‐Davis (2008)
10.1016/S0003-4975(00)01595-2
Myasthenia gravis: recommendations for clinical research standards. Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of America.
A. Jaretzki (2000)
10.1016/j.jpsychores.2008.09.018
Medically unexplained symptoms, somatisation disorder and hypochondriasis: course and prognosis. A systematic review.
Tim C. olde Hartman (2009)



This paper is referenced by
10.1093/ejcts/ezu309
Prognostic factors of remission in myasthenia gravis after thymectomy.
Zhifeng Mao (2015)
10.1111/j.1468-1331.2011.03621.x
Risk of extrathymic cancer in patients with myasthenia gravis in Taiwan: a nationwide population‐based study
C. Liu (2012)
10.1111/ane.12233
Myasthenia gravis epidemiology in a national cohort; combining multiple disease registries
J. B. Andersen (2014)
10.1111/j.1468-1331.2011.03594.x
Publishing changes and information delivery in the clinical neurosciences
A. H. Schapira (2011)
Thymic pathological examination of non-thymomatous myasthenia gravis patients: A pilot study for prediction of outcome
Zeinab Peimani (2014)
10.1017/sjp.2013.59
Facial affect recognition in myasthenia gravis.
Esther Lázaro (2013)
10.1007/s10072-016-2556-3
Major motor-functional determinants associated with poor self-reported health-related quality of life in myasthenia gravis patients
D. Cioncoloni (2016)
10.1002/mus.25174
Single fiber EMG as a prognostic tool in myasthenia gravis
M. Baruca (2016)
10.1002/mus.25654
Start high, then go low: An effective strategy in the treatment of myasthenia gravis
N. Silvestri (2017)
10.1080/00207454.2016.1202952
β2-Adrenergic receptor gene polymorphisms in the relapse of myasthenia gravis with thymus abnormality
L. Wang (2017)
10.1007/s00415-019-09667-5
Frequency and clinical features of treatment-refractory myasthenia gravis
J. Rath (2019)
10.1016/B978-0-323-08500-7.00079-5
Chapter 64 – Myasthenia Gravis
Corey R Fehnel (2013)
10.1097/MD.0000000000019100
Lower number of plasma exchange sessions and glomerular filtration rate decline are associated with second relapses in patients with myasthenia gravis
V. Premužić (2020)
10.1002/mus.23964
Late‐onset myasthenia gravis: A review when incidence in older adults keeps increasing
Nuha M. Alkhawajah (2013)
10.1016/j.jneuroim.2015.10.018
Clinical outcome of generalized myasthenia gravis in Hong Kong Chinese
C. Y. Lee (2015)
10.1002/mus.25463
Activity limitations in myasthenia gravis and relation to clinical variables
Robert H.P. Meel (2017)
Study of demographic, clinical, laboratory and electromyographic symptoms in Myasthenia Gravis patients referred to the neurology clinic of Rasoul Akram hospital in 2015
Y. Sadri (2015)
10.1002/mus.25205
Factors affecting outcome in myasthenia gravis
J. B. Andersen (2016)
10.4172/2155-9562.S11-004
Ocular Neostigmine Drops for Diagnosing Myasthenia Gravis
M. Salih (2013)
10.1590/0004-282X20160129
Brazilian-Portuguese translation, cross-cultural adaptation and validation of the Myasthenia Gravis Composite scale. A multicentric study.
E. F. Oliveira (2016)
10.1186/s12883-017-0857-7
Clinical predictors for the prognosis of myasthenia gravis
L. Wang (2017)
10.36290/neu.2016.033
Cardiac function in hypertensive patients with metabolic syndrome and microalbuminuria
Jiří Piťha (2016)
10.17784/MTPREHABJOURNAL.2016.14.342
Brazilian translation, cross-cultural adaptation and validation of the Myasthenia Gravis Composite scale and Quantitative Myasthenia gravis testing form: a multicentric study protocol.
E. F. Oliveira (2016)
10.1371/journal.pone.0164092
Effect of Gender, Disease Duration and Treatment on Muscle Strength in Myasthenia Gravis
G. Citirak (2016)
10.2165/00003495-198326020-00004
Myasthenia Gravis
C. Havard (2012)
10.1177/1756286420949808
Gender issues of antibody-mediated diseases in neurology: (NMOSD/autoimmune encephalitis/MG)
Ayse Altintas (2020)
10.1016/j.jneuroim.2015.03.018
Prognostic factors for exacerbations and emergency treatments in myasthenia gravis
Robert H. P. de Meel (2015)
10.1056/NEJMra1602678
Myasthenia Gravis.
N. E. Gilhus (2016)
10.1590/0004-282X20130180
Brazilian cross-cultural translation and adaptation of the "Questionnaire of Life Quality Specific for Myasthenia Gravis - 15 items".
A. M. Mourão (2013)
10.1097/CND.0000000000000122
Low-Dose Medication and Long-Term Outcome in Myasthenia Gravis
Salomi Salins (2016)
10.36290/NEU.2016.033
Klinické aspekty při léčbě myasthenia gravis
J. Piťha (2016)
THYMIC PATHOLOGICAL EXAMINATION OF NON-THYMOMATOUS MYASTHENIA GRAVIS PATIENTS: A PILOT STUDY FOR PREDICTION OF OUTCOME (SHORT COMMUNICATION)
Peimani Zeinab (2014)
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