Myasthenia gravis epidemiology and demographics: Difference between revisions

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==Epidemiology and Demographics==
== Overview ==
Myasthenia gravis occurs in all ethnic groups and both genders. It most commonly affects women under 40 - and people from 50 to 70 years old of either sex, but it has been known to occur at any age. Younger patients rarely have thymoma. The prevalence in the [[United States]] is estimated at 20 cases per 100,000 in the United States.<ref name="MGFA">{{cite web | title=What is Myasthenia Gravis (MG)? | url=http://www.myasthenia.org/amg_whatismg.cfm | publisher=Myasthenia Gravis Foundation of America}}</ref>  Risk factors are the female gender with ages 20 – 40, familial myasthenia gravis, D-penicillamine ingestion (drug induced myasthenia), and having other autoimmune diseases.
The [[incidence]] of Myasthenia gravis is approximately 7-23 new cases per year. The [[prevalence]] of Myasthenia gravis is approximately 70-320 per million and increasing since 20<sup>th</sup> century. The [[age of onset]] in Myasthenia gravis follows a bimodal distribution. The early type (before age of 50) is [[female]] predominant and the late type (after age of 60) is [[male]] predominant. Between the age of 50-60 there is no significant different between [[male]] and [[female]]. Some studies demonstrated that the [[incidence]], [[prevalence]] and the severity of this disease is higher in African/Americans.


Three types of myasthenia symptoms in children can be distinguished:
==Incidence==
# Neonatal: In 12% of the pregnancies with a mother with MG, she passes the antibodies to the infant through the [[placenta]] causing neonatal myasthenia gravis. The symptoms will start in the first two days and disappear within a few weeks after birth. With the mother it is not uncommon for the symptoms to even improve during pregnancy, but they might worsen after labor.
The [[incidence]] of Myasthenia gravis is approximately 7-23 new cases per year.<ref name="pmid20565885">{{cite journal |vauthors=Carr AS, Cardwell CR, McCarron PO, McConville J |title=A systematic review of population based epidemiological studies in Myasthenia Gravis |journal=BMC Neurol |volume=10 |issue= |pages=46 |date=June 2010 |pmid=20565885 |pmc=2905354 |doi=10.1186/1471-2377-10-46 |url=}}</ref><ref name="pmid22581533">{{cite journal |vauthors=Heldal AT, Eide GE, Gilhus NE, Romi F |title=Geographical distribution of a seropositive myasthenia gravis population |journal=Muscle Nerve |volume=45 |issue=6 |pages=815–9 |date=June 2012 |pmid=22581533 |doi=10.1002/mus.23271 |url=}}</ref><ref name="pmid25060190">{{cite journal |vauthors=Mombaur B, Lesosky MR, Liebenberg L, Vreede H, Heckmann JM |title=Incidence of acetylcholine receptor-antibody-positive myasthenia gravis in South Africa |journal=Muscle Nerve |volume=51 |issue=4 |pages=533–7 |date=April 2015 |pmid=25060190 |doi=10.1002/mus.24348 |url=}}</ref><ref name="pmid26573434">{{cite journal |vauthors=Breiner A, Widdifield J, Katzberg HD, Barnett C, Bril V, Tu K |title=Epidemiology of myasthenia gravis in Ontario, Canada |journal=Neuromuscul. Disord. |volume=26 |issue=1 |pages=41–6 |date=January 2016 |pmid=26573434 |doi=10.1016/j.nmd.2015.10.009 |url=}}</ref>
# Congenital: Children of a healthy mother can, very rarely, develop myasthenic symptoms beginning at birth. This is called [[Congenital Myasthenic Syndrome]] or CMS. Other than Myasthenia gravis, CMS is not caused by an autoimmune process, but due to synaptic malformation, which in turn is caused by genetic [[mutations]]. Thus, CMS is a [[hereditary disease]]. More than 11 different mutations have been identified and the inheritance pattern is typically [[recessive gene|autosomal recessive]].
== Prevalence ==
# Juvenile myasthenia gravis: myasthenia occurring in childhood but after the peripartum period.
The [[prevalence]] of Myasthenia gravis is approximately 70-320 per million and increasing since 20<sup>th</sup> century.<ref name="pmid20565885">{{cite journal |vauthors=Carr AS, Cardwell CR, McCarron PO, McConville J |title=A systematic review of population based epidemiological studies in Myasthenia Gravis |journal=BMC Neurol |volume=10 |issue= |pages=46 |date=June 2010 |pmid=20565885 |pmc=2905354 |doi=10.1186/1471-2377-10-46 |url=}}</ref><ref name="pmid22581533">{{cite journal |vauthors=Heldal AT, Eide GE, Gilhus NE, Romi F |title=Geographical distribution of a seropositive myasthenia gravis population |journal=Muscle Nerve |volume=45 |issue=6 |pages=815–9 |date=June 2012 |pmid=22581533 |doi=10.1002/mus.23271 |url=}}</ref><ref name="pmid26573434">{{cite journal |vauthors=Breiner A, Widdifield J, Katzberg HD, Barnett C, Bril V, Tu K |title=Epidemiology of myasthenia gravis in Ontario, Canada |journal=Neuromuscul. Disord. |volume=26 |issue=1 |pages=41–6 |date=January 2016 |pmid=26573434 |doi=10.1016/j.nmd.2015.10.009 |url=}}</ref><ref name="pmid26851892">{{cite journal |vauthors=Santos E, Coutinho E, Moreira I, Silva AM, Lopes D, Costa H, Silveira F, Nadais G, Morais H, Martins J, Branco MC, Veiga A, Silva RS, Ferreira A, Sousa F, Freijo M, Matos I, André R, Negrão L, Fraga C, Santos M, Sampaio M, Lopes C, Leite MI, Gonçalves G |title=Epidemiology of myasthenia gravis in Northern Portugal: Frequency estimates and clinical epidemiological distribution of cases |journal=Muscle Nerve |volume=54 |issue=3 |pages=413–21 |date=September 2016 |pmid=26851892 |doi=10.1002/mus.25068 |url=}}</ref>
== Age and Gender ==
The [[age of onset]] in Myasthenia gravis follows a bimodal distribution. The early type (before age of 50) is [[female]] predominant and the late type (after age of 60) is [[male]] predominant. Between the age of 50-60 there is no significant different between [[male]] and [[female]].<ref name="pmid23893883">{{cite journal |vauthors=Alkhawajah NM, Oger J |title=Late-onset myasthenia gravis: a review when incidence in older adults keeps increasing |journal=Muscle Nerve |volume=48 |issue=5 |pages=705–10 |date=November 2013 |pmid=23893883 |doi=10.1002/mus.23964 |url=}}</ref>


The congenital myasthenias cause muscle weakness and fatigability similar to those of MG. The symptoms of CMS usually begin within the first two years of life, although in a few forms patients can develop their first symptoms as late as the seventh decade of life. A diagnosis of CMS is suggested by the following:
== Race ==
* Onset of symptoms in infancy or childhood.  
Some studies demonstrated that the [[incidence]], [[prevalence]] and the severity of this disease is higher in African/Americans.<ref name="pmid1407568">{{cite journal |vauthors=Phillips LH, Torner JC, Anderson MS, Cox GM |title=The epidemiology of myasthenia gravis in central and western Virginia |journal=Neurology |volume=42 |issue=10 |pages=1888–93 |date=October 1992 |pmid=1407568 |doi= |url=}}</ref><ref name="pmid19127534">{{cite journal |vauthors=Oh SJ, Morgan MB, Lu L, Hatanaka Y, Hemmi S, Young A, Claussen GC |title=Racial differences in myasthenia gravis in Alabama |journal=Muscle Nerve |volume=39 |issue=3 |pages=328–32 |date=March 2009 |pmid=19127534 |pmc=2814330 |doi=10.1002/mus.21191 |url=}}</ref>  
* Weakness which increases as muscles tire.
* A decremental EMG response, on low frequency, of the compound muscle action potential (CMAP).
* No anti-AChR or MuSK antibodies.
* No response to immunosuppressant therapy.
* Family history of symptoms which resemble CMS.  


The symptoms of CMS can vary from mild to severe. It is also common for patients with the same form, even members of the same family, to be affected to differing degrees. In most forms of CMS weakness does not progress, and in some forms, the symptoms may diminish as the patient gets older. Only rarely do symptoms of CMS become worse with time.
==Region==
*The majority of [disease name] cases are reported in [geographical region].
 
*[Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].


==References==
==References==
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[[Category:Autoimmune diseases]]
[[Category:Autoimmune diseases]]
[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Rheumatology]]
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The incidence of Myasthenia gravis is approximately 7-23 new cases per year. The prevalence of Myasthenia gravis is approximately 70-320 per million and increasing since 20th century. The age of onset in Myasthenia gravis follows a bimodal distribution. The early type (before age of 50) is female predominant and the late type (after age of 60) is male predominant. Between the age of 50-60 there is no significant different between male and female. Some studies demonstrated that the incidence, prevalence and the severity of this disease is higher in African/Americans.

Incidence

The incidence of Myasthenia gravis is approximately 7-23 new cases per year.[1][2][3][4]

Prevalence

The prevalence of Myasthenia gravis is approximately 70-320 per million and increasing since 20th century.[1][2][4][5]

Age and Gender

The age of onset in Myasthenia gravis follows a bimodal distribution. The early type (before age of 50) is female predominant and the late type (after age of 60) is male predominant. Between the age of 50-60 there is no significant different between male and female.[6]

Race

Some studies demonstrated that the incidence, prevalence and the severity of this disease is higher in African/Americans.[7][8]  

Region

  • The majority of [disease name] cases are reported in [geographical region].
  • [Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].

References

  1. 1.0 1.1 Carr AS, Cardwell CR, McCarron PO, McConville J (June 2010). "A systematic review of population based epidemiological studies in Myasthenia Gravis". BMC Neurol. 10: 46. doi:10.1186/1471-2377-10-46. PMC 2905354. PMID 20565885.
  2. 2.0 2.1 Heldal AT, Eide GE, Gilhus NE, Romi F (June 2012). "Geographical distribution of a seropositive myasthenia gravis population". Muscle Nerve. 45 (6): 815–9. doi:10.1002/mus.23271. PMID 22581533.
  3. Mombaur B, Lesosky MR, Liebenberg L, Vreede H, Heckmann JM (April 2015). "Incidence of acetylcholine receptor-antibody-positive myasthenia gravis in South Africa". Muscle Nerve. 51 (4): 533–7. doi:10.1002/mus.24348. PMID 25060190.
  4. 4.0 4.1 Breiner A, Widdifield J, Katzberg HD, Barnett C, Bril V, Tu K (January 2016). "Epidemiology of myasthenia gravis in Ontario, Canada". Neuromuscul. Disord. 26 (1): 41–6. doi:10.1016/j.nmd.2015.10.009. PMID 26573434.
  5. Santos E, Coutinho E, Moreira I, Silva AM, Lopes D, Costa H, Silveira F, Nadais G, Morais H, Martins J, Branco MC, Veiga A, Silva RS, Ferreira A, Sousa F, Freijo M, Matos I, André R, Negrão L, Fraga C, Santos M, Sampaio M, Lopes C, Leite MI, Gonçalves G (September 2016). "Epidemiology of myasthenia gravis in Northern Portugal: Frequency estimates and clinical epidemiological distribution of cases". Muscle Nerve. 54 (3): 413–21. doi:10.1002/mus.25068. PMID 26851892.
  6. Alkhawajah NM, Oger J (November 2013). "Late-onset myasthenia gravis: a review when incidence in older adults keeps increasing". Muscle Nerve. 48 (5): 705–10. doi:10.1002/mus.23964. PMID 23893883.
  7. Phillips LH, Torner JC, Anderson MS, Cox GM (October 1992). "The epidemiology of myasthenia gravis in central and western Virginia". Neurology. 42 (10): 1888–93. PMID 1407568.
  8. Oh SJ, Morgan MB, Lu L, Hatanaka Y, Hemmi S, Young A, Claussen GC (March 2009). "Racial differences in myasthenia gravis in Alabama". Muscle Nerve. 39 (3): 328–32. doi:10.1002/mus.21191. PMC 2814330. PMID 19127534.

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