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西班牙队列中家族性自身免疫性重症肌无力患病率的研究。

Study of the prevalence of familial autoimmune myasthenia gravis in a Spanish cohort.

作者信息

Salvado Maria, Canela Merce, Ponseti Jose Maria, Lorenzo Laura, Garcia Cecilia, Cazorla Sonia, Gili Gisela, Raguer Nuria, Gamez Josep

机构信息

Myasthenia Gravis Unit, Clinic of Neuromuscular Disorders and Rare Diseases, Neurology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.

Myasthenia Gravis Unit, Clinic of Neuromuscular Disorders and Rare Diseases, Neurology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.

出版信息

J Neurol Sci. 2016 Jan 15;360:110-4. doi: 10.1016/j.jns.2015.11.049. Epub 2015 Nov 27.

Abstract

BACKGROUND

Myasthenia gravis (MG) is an autoimmune disease caused by a failure of neuromuscular transmission. Familial clustering has been reported despiteMG usually manifesting as a sporadic condition presumed not to be inherited. Our study investigated the prevalence of FAMG in a Spanish cohort, characterizing their phenotype,antibody titres and thymus findings.

MATERIAL/METHODS: We investigated the presence of familial cases in 462 MG patients, characterizing by age and MGFA class at debut, quantitative MG score, antibody titres, MGFA post-intervention status and thymus pathology.

RESULTS

Sixteen cases from8 unrelated pedigrees were identified. The prevalence of FAMG caseswas 3.46%.Mean age at onset was 57.8 ± 17.4 years (range=23–82). Distribution at debut was: 6 ocular, 4 IIa, 4IIb, 1 IIIa and 1 IIIb. Thymoma was identified in two of the 7 thymectomized individuals.

CONCLUSIONS

The prevalence of FAMG in Spain is similar to other populations. Post-intervention status did not differ from sporadic autoimmune MG. As in other neuromuscular disorders, phenotype and inheritance heterogeneity are present in FAMG. In addition to the interfamilial heterogeneity observed, members of the same family affected with FAMG may even present different ages of onset, severity and thymus involvement. Further studies are necessary to clarify the role of genetic risk factors in this form of autoimmune MG.

摘要

背景

重症肌无力(MG)是一种由神经肌肉传递功能障碍引起的自身免疫性疾病。尽管MG通常表现为散发性疾病,被认为不具有遗传性,但仍有家族聚集现象的报道。我们的研究调查了西班牙队列中家族性重症肌无力(FAMG)的患病率,对其表型、抗体滴度和胸腺检查结果进行了特征描述。

材料/方法:我们调查了462例MG患者中家族性病例的存在情况,根据发病时的年龄和MGFA分级、定量MG评分、抗体滴度、MGFA干预后状态和胸腺病理学进行特征描述。

结果

确定了来自8个不相关家系的16例病例。FAMG病例的患病率为3.46%。发病时的平均年龄为57.8±17.4岁(范围=23-82岁)。发病时的分布情况为:6例眼肌型,4例IIa型,4例IIb型,1例IIIa型和1例IIIb型。在7例接受胸腺切除术的患者中,有2例发现胸腺瘤。

结论

西班牙FAMG的患病率与其他人群相似。干预后的状态与散发性自身免疫性MG没有差异。与其他神经肌肉疾病一样,FAMG存在表型和遗传异质性。除了观察到的家系间异质性外,受FAMG影响的同一家族成员甚至可能表现出不同的发病年龄、严重程度和胸腺受累情况。需要进一步研究以阐明遗传风险因素在这种自身免疫性MG形式中的作用。

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