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Muscle Nerve ; 57(4): 603-609, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-28877546

RESUMO

INTRODUCTION: In this study we determined the clinical, paraclinical, and treatment-related features of juvenile myasthenia gravis (JMG) as well as the clinical course in a cohort of French children. METHODS: We conducted a retrospective study of 40 patients with JMG at 2 French pediatric neurology departments from April 2004 to April 2014. RESULTS: Among the patients, 70% had generalized JMG, 52% had positive acetylcholine receptor antibodies, 8% had muscle-specific kinase antibodies, and 40% were seronegative. Treatment with acetylcholinesterase inhibitors was effective and sufficient in 47% of patients. The 6 patients with generalized JMG treated with rituximab and/or immunoadsorption showed improvement. Thirty percent of the patients required hospitalization in an intensive care unit during follow-up (mean 4.7 years). Remission without treatment occurred in 18% of patients. DISCUSSION: As with adults, JMG has high morbidity, particularly among children with generalized symptoms, and rituximab should be considered early in the course of the disease as a second-line treatment. Muscle Nerve 57: 603-609, 2018.


Assuntos
Miastenia Gravis/fisiopatologia , Adolescente , Idade de Início , Autoanticorpos/imunologia , Criança , Pré-Escolar , Progressão da Doença , Feminino , França , Hospitalização/estatística & dados numéricos , Humanos , Técnicas de Imunoadsorção , Unidades de Terapia Intensiva/estatística & dados numéricos , Estudos Longitudinais , Masculino , Miastenia Gravis/imunologia , Miastenia Gravis/terapia , Receptores Proteína Tirosina Quinases/imunologia , Receptores Colinérgicos/imunologia , Indução de Remissão , Estudos Retrospectivos , Rituximab/uso terapêutico
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