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[重症肌无力——性别因素与计划生育]

[Myasthenia gravis-Gender aspects and family planning].

作者信息

Hoffmann Sarah, Verlohren Stefan, Herdick Meret

机构信息

Department of Neurology, Neuroscience Clinical Research Center (NCRC) and Integrated Myasthenia Gravis Center, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.

Department of Obstetrics, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland.

出版信息

Nervenarzt. 2024 Apr;95(4):316-328. doi: 10.1007/s00115-024-01640-6. Epub 2024 Mar 18.

Abstract

BACKGROUND

There is evidence that gender-specific differences can influence the diagnostics, treatment and long-term disease course of myasthenia gravis (MG). In women the diagnosis is often made during childbearing age.

OBJECTIVE

Gender-specific differences in MG and relevant aspects in routine clinical practice are presented. In addition, current studies on family planning, pregnancy and childbirth in MG are highlighted and treatment recommendations are derived.

MATERIAL AND METHODS

Narrative literature review.

RESULTS

In addition to sociodemographic data, gender-specific differences encompass clinical as well as paraclinical factors, such as disease severity and antibody status. With few exceptions pregnancy is possible with good maternal and neonatal outcome. During pregnancy and peripartum, children of MG patients should be closely monitored for early detection and treatment of potential syndromes caused by diaplacental transfer of maternal antibodies.

CONCLUSION

Gender-specific factors can influence the course of MG. Adequate medical counselling and multidisciplinary collaboration are essential for MG patients who wish to have children.

摘要

背景

有证据表明,性别差异会影响重症肌无力(MG)的诊断、治疗及疾病的长期病程。女性的诊断通常在育龄期作出。

目的

阐述MG中的性别差异及常规临床实践中的相关方面。此外,重点介绍目前关于MG患者计划生育、妊娠及分娩的研究,并得出治疗建议。

材料与方法

叙述性文献综述。

结果

除社会人口统计学数据外,性别差异还包括临床及辅助临床因素,如疾病严重程度和抗体状态。除少数例外情况,妊娠是可行的,母婴结局良好。在妊娠及围产期,应密切监测MG患者的子女,以便早期发现和治疗由母体抗体经胎盘转移引起的潜在综合征。

结论

性别因素可影响MG的病程。对于希望生育的MG患者,充分的医学咨询和多学科协作至关重要。

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