1. Myasthenia gravis in South Africans: racial differences in clinical manifestations.
- Author
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Heckmann JM, Owen EP, and Little F
- Subjects
- Adolescent, Adult, Age of Onset, Autoantibodies genetics, Black People, Cohort Studies, Disease Progression, Female, Genetic Predisposition to Disease genetics, Humans, Immunity, Innate, Immunosuppression Therapy standards, Male, Middle Aged, Myasthenia Gravis epidemiology, Ophthalmoplegia epidemiology, Ophthalmoplegia ethnology, Ophthalmoplegia physiopathology, Phenotype, Racial Groups ethnology, Racial Groups genetics, Receptors, Cholinergic immunology, South Africa epidemiology, South Africa ethnology, Thymectomy standards, Thymectomy statistics & numerical data, White People, Myasthenia Gravis ethnology, Myasthenia Gravis physiopathology
- Abstract
We present data on the phenotypic variation in myasthenia gravis of 205 subjects from a multi-racial South African cohort. Consecutive subjects seen more than twice from 1996 to 2006, were included. Documented observational data included a myasthenia gravis and extra-ocular eye muscle score. Results showed Black subjects were more likely than Whites to develop treatment-resistant complete ophthalmoplegia and ptosis (18% vs. 2%; p=0.041). Of the 14 patients with this phenotype, 13 had generalised disease and positive AChR antibodies. Despite similar sized cohorts, White subjects were more likely than Blacks to develop generalised myasthenia poorly responsive to therapy (p=0.005). There were no significant racial differences in the time between diagnosis to initiation of therapy, or the performance and timing of thymectomy. The racial variation in some phenotypic features of myasthenia gravis and outcome to therapy, highlights the need to study biological factors in different subgroups to develop a more rational approach to immuno-suppressive therapy.
- Published
- 2007
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