Impact des maladies thyroïdiennes auto-immunes sur la MG

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Impact des maladies thyroïdiennes auto-immunes sur la MG

Message par Pboulanger » 11 août 2016 11:30


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Prevalence and impact of autoimmune thyroid disease on myasthenia gravis course
Justyna Kubiszewska 1  | Beata Szyluk 1  | Piotr Szczudlik 1  | Zbigniew Bartoszewicz 2  |
Małgorzata Dutkiewicz 3  | Maksymilian Bielecki 4  | Tomasz Bednarczuk 2  |
Anna Kostera-Pruszczyk
First published: 4 August 2016
DOI: 10.1002/brb3.537

  • Objectives

    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.


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