Prevalence and impact of autoimmune thyroid disease on myasthenia gravis course
Justyna Kubiszewska , Beata Szyluk , Piotr Szczudlik , Zbigniew Bartoszewicz , Małgorzata Dutkiewicz , Maksymilian Bielecki , Tomasz Bednarczuk , Anna Kostera-Pruszczyk
AbstractObjectives: Autoimmune thyroid diseases (ATDs) frequently accompany myasthenia gravis (MG) and may influence its course. We aimed to determine the association and impact of ATD with early-(< 50 years), late-onset MG, or thymoma-MG. Materials and Methods: Prevalence of ATD was measured in a cross-sectional study of 343 consecutive patients with MG (236 F, 107 M) aged 4–89 years; 83.8% were seropositive, in 2.9%, anti-MuSK antibodies were detected. Concentrations of antithyroid peroxidase antibodies, antithyroglobulin antibodies, antithyrotropin receptor antibodies, and TSH level were measured in all patients. MG clinical course, treatment received, and treatment results were evaluated. Results: Autoimmune thyroid diseases were diagnosed in 92 (26.8%) of MG patients including 4.4% with Graves (GD), 9% with Hashimoto thyroiditis (HT), and 13.4% with antithyroid antibodies only. GD patients had ocular symptoms more often than patients with antithyroid antibodies or HT (p = .008). ATD prevalence was comparable in MG with early and late onset, while non-ATDs were more frequent in thymoma-MG (p = .049). Immunosuppressive therapy was less frequently needed in the patients with MG and ATD, indirectly indicating milder MG course (p = .005). Risk of myasthenic crisis and the results of treatment did not differ between patients with and without ATD. Conclusions: Autoimmune thyroid diseases are frequently accompanied by early-and late-onset MG, while thymoma-MG is related to higher risk of non-ATD. Myasthenia coexisting with ATD follows milder course than MG alone.
|Journal series||Brain and Behavior, ISSN 2162-3279, (A 20 pkt)|
|Publication size in sheets||0.3|
|Keywords in English||autoimmune thyroid diseases, Graves' disease, Hashimoto's thyroiditis, myasthenia gravis|
|Publication indicators||: 2016 = 0.707; : 2016 = 2.157 (2) - 2016=2.506 (5)|
|Citation count*||16 (2019-10-20)|
* presented citation count is obtained through Internet information analysis and it is close to the number calculated by the Publish or Perish system.