Muhammad Azhar Saeed, Muhammad Amjad, Muhammad Tariq.
Myasthenia gravis: a comparison of clinical presentation and diagnostic tests among different gender groups in Pakistani population.
APIMS Jan ;6(4):186-90.

Objective: To study the clinical presentation and diagnostic tests utilized for the confirmation of Myasthenia Gravis (MG) in different gender groups. Study design: Cross Sectional Study. Place and Duration of Study: This study was conducted at Fauji Foundation Hospital, Rawalpindi and Pakistan Myasthenic Welfare Organization, Islamabad, from Feb 2008 to Jan 2010 Patients and Methods: A total of 64 patient having at least one diagnostic test positive for MG, were selected on purposive, non probability group basis, All those were excluded that lack pharmacological response, laboratory or electro-diagnostic result, in favor of MG. Comparison was made between two groups (male and female). Different diagnostic modalities utilized for the confirmation of MG were analyzed. Results: There were 32 patients in each group. Mean age at onset of MG was 24.78 ± 9.09 and 33.56 ± 12.05 in female and male group respectively (p=0.002). Most of the patients (79.69%) had onset before 40 yrs of age and out of these 58.82% were females. Major clinical presentation includes ocular symptoms in 90.62% & 84.37% followed by easy fatigability in 81.25% & 71.87%, bulbar weakness in 46.87% & 56.25% and proximal limb weakness in 32.25% & 24.19% in female and male patients, respectively. Investigations utilized for confirmation of MG are Anti AChR antibody (87.1%), Repetitive Nerve Stimulation (69.35%) & Neostigmine test (20.97%). Thymic hyperplasia was found in 90% and 22% of thymectomy samples in female and male respectively. Conclusion: The clinical presentation of MG in both gender were comparable. Most of the patients had onset before 40 yrs of age and thymic hyperplasia was more common in this group. Commonly utilized investigations include AChR antibody, RNS & Neostigmine test.

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