The characteristics of juvenile myasthenia gravis among South Africans

dc.contributor.authorHeckmann, J. M.
dc.contributor.authorHansen, P.
dc.contributor.authorVan Toorn, R.
dc.contributor.authorLubbe, E.
dc.contributor.authorJanse Van Rensburg, E.
dc.contributor.authorWilmshurst, J. M.
dc.identifier.citationHeckmann, J. M. et al. 2012. The characteristics of juvenile myasthenia gravis among South Africans. South African Medical Journal, 102(6):532-536.
dc.identifier.issn2078-5135 (online)
dc.identifier.issn0256-9574 (print)
dc.descriptionThe original publication is available at
dc.description.abstractObjectives. To report the characteristics of juvenile-onset (<20 years) myasthenia gravis (MG) in Africa. Subjects and methods. Six South African centres collected data which included acetylcholine receptor-antibody (AChR-ab) status, delay before diagnosis, MG Foundation of America grade at onset, maximum severity and severity at last visit, therapies, outcomes and complications. Results. We report on 190 individuals with a 4-year median follow-up (interquartile range (IQR) 1 - 8). The median age at symptom onset was 7 years (IQR 4 - 14). Ocular MG (26%) occurred among younger children (mean 5.1 years) compared with those developing generalised MG (74%) (mean 10.2 years) (p=0.0004). Remissions were obtained in 45% of generalised and 50% of ocular MG patients, of whom the majority received immunosuppressive treatment, mainly prednisone. Children with post-pubertal onset had more severe MG, but deaths were infrequent. Thymectomies were performed in 43% of those with generalised MG who suffered greater maximum disease severity (p=0.002); there was a trend towards more remissions in the thymectomy group compared with the non-thymectomy group (p=0.057). There was no racial variation with respect to AChR-ab status, maximum severity, or use of immunosuppression. However, 23% of children of African genetic ancestry developed partial or complete ophthalmoplegia as a complication of generalised MG (p=0.002). Conclusion. Younger children developed ocular MG and older children generalised MG. Persistent ophthalmoplegia developing as a MG complication is not uncommon among juveniles of African genetic ancestry. A successful approach to the management of this complication that causes significant morbidity is, as yet, unclear.en_ZA
dc.format.extentpp. 532-536 : ill.
dc.publisherHealth and Medical Publishing Group (HMPG)
dc.subjectMyasthemia gravis -- South Africa -- Cross-cultural studiesen_ZA
dc.subjectOpthalmoplegia -- South Africa -- Cross-cultural studiesen_ZA
dc.subjectMyasthemia gravis -- South Africa -- Diagnosis -- Researchen_ZA
dc.subjectMyasthemia gravis -- South Africa -- Treatment -- Researchen_ZA
dc.subjectOcular myasthemia gravis in children -- South Africa -- Managementen_ZA
dc.titleThe characteristics of juvenile myasthenia gravis among South Africansen_ZA
dc.description.versionPublishers’ version
dc.rights.holderAuthors retain copyrighten_ZA

Files in this item


This item appears in the following Collection(s)