Development of Generalized Disease at 2 Years in Patients With Ocular Myasthenia Gravis

摘要: Background Generalized myasthenia gravis will develop in more than 50% of patients who present with ocular gravis, typically within 2 years. The optimal treatment including the use corticosteroids, remains controversial. In addition, prevalence thymoma and performance edrophonium chloride test for remain unknown. Objective To assess effect oral corticosteroid therapy on frequency development generalized years, incidence thymoma, amount needed a positive result gravis. Methods We reviewed an database 147 patients. Patients underwent measurement acetylcholine receptor (AChR) antibody levels chest computed tomography. Unless contraindicated, diplopia were recommended prednisone, up to 40 60 mg/d, dosage tapered 5 6 weeks. Most continued receive daily or alternate-day doses 2.5 10 mg prevent diplopia. not given prednisone (untreated group) received pyridostigmine bromide no medication. After diagnosis, we documented signs symptoms performed 2-year follow-up 94 Results mean dose give response was 3.3 (SD, 1.6 mg) ptosis 2.6 1.1 motor dysfunction. Thymoma occurred 1 patient (0.7%). developed years 4 58 treated 13 36 untreated odds ratio (OR) disease group 0.13 (95% confidence interval [CI], 0.04-0.45) compared group. AChR level predictive at but risk greater abnormal (OR, 6.33; 95% CI, 1.71-23.42). Logistic regression that included age, level, yielded significance only 7.03; 1.35-36.64) 0.06; 0.01-0.30). Conclusions At appears reduce 7% contrast 36% did prednisone. Thymoma, although uncommon, occurs Only small amounts are diagnose