[The prognosis of juvenile myasthenia gravis]

Abstract

In 18 patients with juvenile myasthenia gravis (MG) the mean age of disease-onset was 12.1 years. The mean observation time was 6.8 years. After classification with regard to the clinical severity of the disease (Ossermann, 1958) 4 patients (22%) could be assigned to type I, 10 patients (56%) to type II A, 2 patients (11%) to type II B, and 2 patients (11%) to type III. 14 patients (77%) could be assigned to type I and type II A, both of them rather benign types. All 4 male patients belonged to this group. The tensilon test, investigated in 15 patients, showed a positive result in 13 cases (87%). The repetitive stimulation was done in 13 patients and was positive only in 6 cases (46%). Investigations in MG-patients without limitation of age showed positive results in about 70%. Increased levels of acetylcholin-receptor-antibody were found in 10 of 11 patients (91%). In 8 patients with the diagnosis MG, type II A and III, a thymectomy was done, 16 patients received cholinesterase-blockers, 1 patient with type II A, and both patients in group III received additionally azathioprin. In 1 patient with type III plasmapheresis was done. 75% of all thymectic patients showed a remission or improvement. Related to all 18 patients we found in 16 cases (89%) a remission or correction of the symptoms. In summary the prognosis in the group of our patients with juvenile myasthenia gravis was good.