Résumé :
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Objective: 62 consecutive patients with myasthenia gravis (MG) seen between 2004 and 2007 were analyzed for epidemiological characteristics, clinical features, yield of diagnostic tests and outcome in relation to various therapeutic options used. Design/Methods: During 2004 to 2007, a total 64 patients with myasthenia were seen. Results: Male: female ratio was 1.69:1. The mean age of females was 35.08 ±14.82 (range 8 to 68) years. The mean age of male patients was 44.54 ±18.25 years (4 to 75 years). Ptosis was the most common, occurring in 90 % per cent of patients at some stage of the illness Most of patients were in grade IIb on presentation. 20 % of ocular myasthenia patients developed generalized myasthenia in 2 years.11 out of 62 (17.7%) patients had autoimmune diseases (Females >Males).Acetylcholine receptor antibody test was positive in 37 out of 53 (69.8%), whereas it was positive in only one of 9 patients (11.1%) of Ocular myasthenia. AntiMuscle Specific Kinase (Anti-Musk antibodies) were positive in two patients who were Acetylcholine receptor antibody negative. Repetitive Nerve Stimulation was found to be more sensitive in generalized myasthenia gravis (84.9 % sensitivity).Neostigmine test was found to be positive in around 90% cases. Contrary to most of western studies, our study showed male predominance. This may be due to a genetic preference or due to socioeconomic structure of Indian society as many female pateints ars neglected by their families and are not brought to health facility.We observed the high prevalence of pulmonary tuberculosis in follow up of patients on long term steroids. Conclusion: Early Osserman's stage, male sex, thymectomy done early in disease course and non-thymomatous histology has good outcome. Thymectomy patients had better outcome compared tonon- thymectomy group, in terms of remission rate. Low dose alternate day steroids and other immunosuppressants were helpful to prevent relapses.
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