“Myasthenia Gravis (MG) is an autoimmune disorder determined by autoantibodies against components of neuromuscular junction, like Acetylcholine Receptor (AchR) and Muscle Specific Kinase (MuSK).
MG may cause both ocular or generalized post-exertion fatigability, with or without finding of Thymoma. Therapies include symptomatic treatment, immunomodulant and immunosuppressive approaches. Clinical manifestations and severity may differ from a patient to another basing on clinical, serological and demographic characteristics.
In this study, 71 consecutive, unselected MG patients (40 females and 31 males), referring to our Unit as outpatients, underwent neurological evaluation with administration of MG Activity of Daily Living (MG ADL) scale. Patients were stratified according to age at onset, serological profile, gender, and presence or absence of thymoma. MG ADL score was then divided in different sub-scores for bulbar, limb and ocular symptoms.
Statistical analysis with Student’s t test showed highly significant differences in MG ADL total score and bulbar and limb sub-scores comparing female and male patients, with higher scores for females. These differences were confirmed when considering anti-AChR+ patients separately. Furthermore, a highly significant difference in MG ADL total score and sub-scores, especially for the bulbar sub-score, was also found comparing early and late-onset patients. No differences were encountered comparing seronegative and anti-AChR+ patients.
Basing on these results, we could infer that, among MG patients, young females, especially with anti-AChR positivity, could develop more severe symptoms during the course of the disease; these differences should be taken into account when evaluating patients in both clinical practice and trials.”