Low serum albumin concentrations are associated with disease severity in patients with myasthenia gravis

Weng, Yiyun; Yang, Dehao; Qian, Meizi; Wei, Maomao; Yin, Fei; Li, Jia; Li, Xiang; Cui, Ying; Ding, Zhangna; He, Yibo; Zhang, Xu

doi:10.1097/md.0000000000005000

Cited by 15 publications

(7 citation statements)

References 20 publications

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“…20 Weng et al demonstrated that low serum albumin concentrations at baseline are associated with disease severity by MGFA clinical classification. 21 The present results also suggest that the presence of hypoalbuminemia affects the low tolerance for infection or complications induced by immunosuppressive therapy in patients with MG.…”

Section: Discussionsupporting

confidence: 61%

Assessment of clinical factors affecting outcome of myasthenia gravis

et al. 2021

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Introduction/Aims: In myasthenia gravis (MG) therapy, achieving Myasthenia Gravis Foundation of America minimal manifestation (MM) or better status is proposed as a desirable target. However, this level of control is often not achieved and clinical factors affecting prognosis remain unclear.Methods: Participants were 104 consecutive patients with MG who visited Osaka Medical College Hospital. We retrospectively assessed the association of clinical and laboratory features at baseline with prognosis. Eighty patients who achieved MM or better status were classified as the good outcome group and the remaining 24 patients were classified as the poor outcome group. Results:The rate of dysphagia at baseline was significantly higher in the poor outcome group than in the good outcome group (P = .002). The levels of serum total protein and albumin at baseline were both significantly lower in the poor outcome group than in the good outcome group (P = .036 and P = .014, respectively). In addition, Controlling Nutritional Status scores at baseline were significantly higher in the poor outcome group than in the good outcome group (P = .043). Multivariate analysis using a Cox proportional hazards model showed that dysphagia (hazard ratio [HR], 6.92; 95% confidence interval [CI], 1.49-40.31) and hypoalbuminemia (HR, 2.57; 95% CI, 1.04-6.57) at baseline were risk factors that predicted prognosis. Discussion: These findings suggest that dysphagia and hypoalbuminemia at baseline are associated with outcomes and are predictive risk factors for poorer outcomes in patients with MG.

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Section: Discussionsupporting

confidence: 61%

Assessment of clinical factors affecting outcome of myasthenia gravis

et al. 2021

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“…The research conducted by Weng et al showed that values of serum albumin were lower in patients with MG in correlation with values of healthy subjects and that it correlated with the degree of clinical presentation, so they could serve as a biomarker for the severity of the disease (15). Our research has not demonstrated a statistically significant difference in the value of the albumin related to the MGFA classification ( Table 6).…”

Section: Discussionmentioning

confidence: 44%

Serum Status of Endogenous Antioxidant M Arkers: Bilirubin, Albumins, Total Proteins and Creatinine in Myasthenia Gravis Patients

Stojanov¹,

Djordjević²,

Ljubisavljević³

et al. 2018

AMM

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There is a lot of evidence pertaining to the ethiopathogenetic importance of oxidative stress in a number of autoimmune diseases, including some immune-mediated neurological diseases such as multiple sclerosis. However, the role of oxidative stress and oxidative status in patients with myasthenia gravis is still an under-researched area. The aim of our research was to compare serum total and direct bilirubin, albumin, total proteins and creatinine levels in myasthenia gravis (MG) patients with healthy controls, and patients with multiple sclerosis (MS). The subjects were divided into three groups (92 MG patients, 68 healthy controls and 74 MS patients). All MG patients were newly diagnosed, classified with MGFA Clinical Classification, and divided into two groups regarding onset age (early < 50 years , late ≥50 years), sex (male, female), thymus pathology (present, absent). Serum antioxidant status was significantly lower in MG and MS group compared to the healthy controls (p < 0.05). There was no significant difference in serum antioxidant status between patients with MG and those with MS. Regarding MGFA Classification we have not found any correlation with serum levels of measured parameters. Our findings suggested that there was a potential role of oxidative process in MG pathology. Among the analyzed parameters, direct bilirubin showed significantly lower value in women, the elderly and in the group of MG patients with pathologically altered thymus gland.

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“…Therefore, it has been considered an attractive diagnostic or prognostic of lots of infectious or autoimmune disorders [ 22 ]. For MG, hypoalbuminemia was confirmed to be correlated with increased disease severity and poorer outcomes [ 23 , 24 ]. Similarly, serum globulin responds to infection and elevates with inflammatory reactions [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Predictive factors for postoperative myasthenic crisis in patients with myasthenia gravis

Wei

Zhang

2023

Interdisciplinary CardioVascular and Thoracic Surgery

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Objectives Thymectomy plays an important role in the comprehensive treatment of myasthenia gravis (MG). The present study aimed to investigate the risk factors for postoperative myasthenic crisis (POMC) in these patients and then establish a predicting model based on preoperatively available indicators. Methods The clinical records of 177 consecutive patients with MG who received extended thymectomy between January 2018 and September 2022 in our department were retrospectively reviewed. Patients were divided into two groups according to whether they developed POMC and needed ventilation support for more than 24 hours. Univariate and multivariate regression analyses were conducted to identify the independent risk factors of POMC. Then a nomogram was constructed to intuitively show the results. Finally, the calibration curve and bootstrap resampling were used to evaluate its performance. Results POMC occurred in 42 (23.7%) patients. By multivariate analysis, body mass index (BMI) (p = 0.029), Osserman classification (p = 0.015), percentage of predicted forced vital capacity (FVC, pred%) (p = 0.044), percentage of predicted forced expiratory volume in the first second (FEV1, pred%) (p = 0.043) and albumin to globulin ratio (AGR) (p = 0.009) were identified as independent risk factors and entered into the nomogram. The calibration curve showed good concordance between the predicted and actual probability of prolonged ventilation. Conclusions Our model is a valuable tool for predicting POMC in MG patients. For those high-risk patients, appropriate preoperative treatment is necessary to improve the symptoms and greater attention to postoperative complications is needed.

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Low serum albumin concentrations are associated with disease severity in patients with myasthenia gravis

Cited by 15 publications

References 20 publications

Assessment of clinical factors affecting outcome of myasthenia gravis

Assessment of clinical factors affecting outcome of myasthenia gravis

Serum Status of Endogenous Antioxidant M Arkers: Bilirubin, Albumins, Total Proteins and Creatinine in Myasthenia Gravis Patients

Predictive factors for postoperative myasthenic crisis in patients with myasthenia gravis

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