Department of Neurology, Third Affiliated Hospital, Guangxi Medical University, Nanning, PR China.
Int J Neurosci. 2011 Mar;121(3):121-9. doi: 10.3109/00207454.2010.539307. Epub 2010 Dec 13.
The course of myasthenia gravis (MG) may get complicated by the development of other autoimmune diseases. Estimates of the frequency of autoimmune diseases will help inform patients and physicians, direct health policy discussion, provide etiologic clues, and optimize the management of MG. However, the frequency of autoimmune diseases in people with MG is still uncertain. A systematic search for English language studies was conducted by MEDLINE and EMBASE from 1960 through 2010. Incidence studies and case series of all MG subtypes with information about autoimmune diseases were included; 25 studies met the inclusion criteria. Although there was considerable heterogeneity, the pooled estimate of the coexisting autoimmune diseases in MG was 13% (95% confidence interval, 12%-14%). Autoimmune thyroid disease seems to occur more frequently than other autoimmune conditions in MG patients. Heterogeneity in study estimates could be explained by ascertainment bias and case mix. Furthermore, autoimmune diseases occurred significantly more often in females and anti-acetylcholine receptor seropositive MG patients. Patients with MG have an increased frequency of coexisting autoimmune diseases. Autoimmune diseases seem to occur more often in female and seropositive MG patients. Further research is needed to expand our understanding of these associations.
重症肌无力 (MG) 的病程可能会因其他自身免疫性疾病的发展而变得复杂。对自身免疫性疾病的频率估计将有助于告知患者和医生，指导卫生政策讨论，提供病因线索，并优化 MG 的管理。然而，MG 患者自身免疫性疾病的频率仍不确定。通过 MEDLINE 和 EMBASE 对 1960 年至 2010 年的英语文献进行了系统检索。纳入了所有 MG 亚型的发病率研究和病例系列，这些研究都提供了自身免疫性疾病的信息；有 25 项研究符合纳入标准。尽管存在很大的异质性，但 MG 患者共存自身免疫性疾病的合并估计值为 13%（95%置信区间，12%-14%）。自身免疫性甲状腺疾病在 MG 患者中的发生频率似乎高于其他自身免疫性疾病。研究估计值的异质性可以用检出偏倚和病例组合来解释。此外，女性和抗乙酰胆碱受体阳性的 MG 患者发生自身免疫性疾病的频率显著更高。MG 患者共存自身免疫性疾病的频率增加。自身免疫性疾病在女性和血清阳性的 MG 患者中似乎更常见。需要进一步研究来扩大我们对这些关联的理解。
