Incidence of AChR Ab‐positive myasthenia gravis in Israel: A population‐based study

Abstract

Background The incidence of myasthenia gravis (MG) has traditionally been low, ranging between 2‐6/106. Several recent epidemiological studies have reported a higher incidence. We, therefore, aimed to assess and characterize the incidence of MG in Israel. Methods We retrospectively reviewed the records of all four laboratories that performed the acetylcholine receptor antibody (AChR Ab) test in Israel between 1994 and 2013 and documented the number of newly diagnosed seropositive MG patients each year. To assure that data indeed reflect only newly diagnosed patients, patient's names and ID numbers were screened at the Hadassah medical center database since 1978, the year when the test was first performed in Israel. In order to calculate the annual incidence of the disease, the population at risk was derived from the annual publication of the Israeli Central Bureau of Statistics. Results The annual incidence of MG for this time period was 13.1/106 inhabitants. The mean incidence of MG between 1994 and 2003 was 7.695/106/y, while the mean incidence between 2004 and 2013 was 18.49/106 (P < .0001). Mean age of diagnosis between 1994 and 2003 was 56.65 ± 0.9351, while between 2004 and 2013, it was 59.89 ± 0.5336 (P = .0012). Male to female (M:F) incidence ratio in the years 1994‐2003 and 2004‐2013 was 2:3.2 and 3:1.8, respectively, reflecting increased incidence among males (P < .0001). Conclusions The incidence of MG in Israel has increased significantly during the last decade, especially among males of older age. These findings may reflect an etiological role of an environmental factor, increased awareness, and increased longevity in general.

Gender issues of antibody-mediated diseases in neurology: (NMOSD/autoimmune encephalitis/MG)

“…In autoimmune MG, epidemiological data show an age-related gender distribution: whereas MG is more frequent in women up to 50 years than in men, with a ratio of 1.6:1.0, late onset and very late onset MG show a predominance of male versus female patients, with a ratio of 1.65:1.0 as shown in a very recent study. 95 In autoimmune LEMS, women and men are rather equally affected, whereas in LEMS associated with cancer, mainly small cell lung cancer, up to 70% of patients are male and older than 60 years. 93,94 Remission appeared to be more likely in early onset MG, but was not shown to be related to gender.…”

Effects of Plasma Exchange Combined with Immunoglobulin Therapy on Consciousness, Immune Function, and Prognosis in Patients with Myasthenia Gravis Crisis: A Prospective Randomized Test

“…IL-6 can induce the transformation of Treg cells to pathogenic Th17 cells and promote the production of antibodies. IL-6 can regulate muscle protein decomposition and cause muscle atrophy, while IL-6 in muscle and peripheral blood of EAMG rats and MG patients is higher compared to that of the PE group and may be related to the severity of the disease [ 6 ]. IL-10 indirectly inhibits the activity of NK cells by inhibiting the antigen presentation function of macrophages and Th1 immune response, thus promoting the proliferation and differentiation of B cells.…”

Integrated proteomics and metabolomics analysis reveals hubs protein and network alterations in myasthenia gravis

“…Current epidemiology indicates that, similar to other autoimmune disorders, the prevalence of MG is growing noticeably [ 14 ]. MG is closely related to the thymus, and thymic abnormalities, such as thymoma, accompany patients with MG [ 15 , 16 ]. Thymoma sustains intra-tumorous thymopoiesis to an alterable level and relates to the TAMG (+) thymoma occurrence.…”