Anutraungkool Thanathon, Padungkiatsagul Tanyatuth, Jindahra Panitha, Vanikieti Kavin
Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Clin Ophthalmol. 2024 Apr 25;18:1125-1132. doi: 10.2147/OPTH.S458979. eCollection 2024.
To report the prevalences of other non-thyroid autoimmune diseases and identify factors associated with their presence in ocular myasthenia gravis (OMG) subjects.
A total of 208 subjects with OMG diagnosis were included. Demographic data, clinical characteristics, the ice-pack test, the acetylcholine receptor (AChR) antibody test, electrophysiology tests (single-fiber electromyography and repetitive nerve stimulation), the presence of thymoma, generalized myasthenia gravis conversion, and the presence of other non-thyroid autoimmune diseases (defined as the presence of at least one other non-thyroid autoimmune disease) were retrospectively reviewed. Factors associated with the presence of other non-thyroid autoimmune diseases were analyzed by univariate and multivariate logistic regression.
Of the total 208 subjects, 21 (10.10%) exhibited the presence of other non-thyroid autoimmune diseases (19 subjects (9.14%) and 2 subjects (0.96%) had one and two other non-thyroid autoimmune diseases, respectively), and systemic lupus erythematosus (SLE) was diagnosed in 9 subjects, followed by Sjogren's syndrome (7 subjects), rheumatoid arthritis (6 subjects), and ankylosing spondylitis (1 subject). Therefore, the prevalences of SLE, Sjogren's syndrome, rheumatoid arthritis, and ankylosing spondylitis in OMG subjects were estimated to be 4.33% (95% confidence interval (CI): 2.29-8.02%), 3.37% (95% CI: 1.64-6.79%), 2.88% (95% CI: 1.33-6.14%), and 0.48% (95% CI: 0.08-2.67%), respectively. Positivity of the AChR antibody was the only significant factor associated with the presence of other non-thyroid autoimmune diseases (odds ratio 4.10, 95% CI: 1.11-15.21, = 0.035).
The presence of other non-thyroid autoimmune diseases was found in approximately 10% of OMG patients, with SLE displaying the highest prevalence. We recommend screening and monitoring for other non-thyroid autoimmune diseases in OMG patients, particularly those with positivity of the AChR antibody.
报告其他非甲状腺自身免疫性疾病的患病率,并确定眼肌型重症肌无力(OMG)患者中与其存在相关的因素。
共纳入208例诊断为OMG的患者。回顾性分析人口统计学数据、临床特征、冰敷试验、乙酰胆碱受体(AChR)抗体检测、电生理检查(单纤维肌电图和重复神经电刺激)、胸腺瘤的存在情况、全身型重症肌无力的转化情况以及其他非甲状腺自身免疫性疾病的存在情况(定义为至少存在一种其他非甲状腺自身免疫性疾病)。通过单因素和多因素逻辑回归分析与其他非甲状腺自身免疫性疾病存在相关的因素。
在总共208例患者中,21例(10.10%)存在其他非甲状腺自身免疫性疾病(19例(9.14%)和2例(0.96%)分别患有1种和2种其他非甲状腺自身免疫性疾病),9例被诊断为系统性红斑狼疮(SLE),其次是干燥综合征(7例)、类风湿关节炎(6例)和强直性脊柱炎(1例)。因此,OMG患者中SLE、干燥综合征、类风湿关节炎和强直性脊柱炎的患病率估计分别为4.33%(95%置信区间(CI):2.29 - 8.02%)、3.37%(95% CI:1.64 - 6.79%)、2.88%(95% CI:1.33 - 6.14%)和0.48%(95% CI:0.08 - 2.67%)。AChR抗体阳性是与其他非甲状腺自身免疫性疾病存在相关的唯一显著因素(比值比4.10,95% CI:1.11 - 15.21,P = 0.035)。
在约10%的OMG患者中发现存在其他非甲状腺自身免疫性疾病,其中SLE患病率最高。我们建议对OMG患者,尤其是AChR抗体阳性的患者进行其他非甲状腺自身免疫性疾病的筛查和监测。