| Objective: The clinical data of 103 children with myasthenia gravis(MG)were analyzed,and the clinical characteristics,curative effect,prognosis and factors influencing prognosis were discussed.Methods: Clinical data of 103 children with myasthenia gravis were collected and followed up by outpatient appointment or telephone(85 patients were successfully followed up for more than 6 months with).The clinical characteristics and auxiliary examination results were retrospectively analyzed,and the therapeutic effect and prognostic factors were evaluated.Results:1.Among the 103 children with myasthenia gravis,the ratio of male to female was 1:1.575,and the average age of onset was 4.33±3.01 years.A total of 52(50.49%)children with onset between 1 and 3 years old.the ratio of urban and rural sources was 1:1.19.2.Among the 103 MG children,19 cases(18.45%)had a history of upper respiratory tract infection,6 cases(5.83%)had a history of periocular trauma before onset,1 cases(0.97%)had a history of vaccination,and the remaining 77 cases(74.75%)had no obvious preonset inducement.3.Among the 103 children,99 cases(96.12%)had the first symptom of blepharoptosis.The first symptom of 2 patients was eye movement disorder(1.94%),1 case(0.97%)showed strabismus as the first symptom.The first symptom of 1 case(0.97%)was systemic,with dyspnea,diplopia and strabismus.4.Onset season: 35 cases(33.98%)in spring,27 cases(26.21%)in summer,19 cases(18.45%)in autumn and 22cases(21.36%)in winter.5.The positive rate of neostigmine experiment was 98.06%(101/103).The positive rate of AChR-Ab was 53.62%(37/69),the positive rate of RyRAb was 21.74%(15/69),and the residual antibody positive rate was low.Antibodies related to myasthenia gravis had no statistical significance with age and sex of onset.Mycoplasma pneumoniae IgM positive rate was 46.53%(47/101),herpes simplex virus IgM positive rate was 23.76%(24/101),para-influenza virus IgM positive rate was 13.86%(14/101),and the residual pathogen positive rate was low.The proportion of thyroid dysfunction was 34.62%(27/78).The proportion of abnormal immunoglobulin was 15.96%(15/94).The proportion of abnormal antibodies related to autoimmune diseases was 41.51%(22/53).The proportion of thymus abnormality was 3.09%(3/97).6.Analysis of 85 children with successful follow-up showed that the total recurrence rate was 27.06%(23/85).The causes of recurrence were as follows: 15 cases of upper respiratory tract infection(65.22%),3 cases of prednisone reduction(13.04%),1 case of cold food(4.35%),and 4 cases of no obvious causes(17.39%).Of the 85 children who were successfully followed up,70 cases received the treatment of IVIG+ChEI+GC,with a remission rate of 87.14%(61/70).There were no patients with generalized myasthenia gravis.7.There was no significant correlation between the gender,age of onset,pathogenesis,first symptoms,mycoplasma infection,AChR-Ab,RyR-Ab,thyroid function,immunoglobulin,autoimmune disease-related antibodies and MG prognosis(P >0.05).Conclusion: 1.Myasthenia gravis in children is mostly seen in the eye muscle type.In addition to the ptosis,it can be accompanied by the symptoms of eye movement disorder,strabismus,diplopia,blurred vision and limb weakness,and rarely turns into GMG.2.The onset season of MG children was mainly in the spring,and mycoplasma infection was the main etiological infection,followed by herpes simplex virus and parainfluenza virus.3.In children,MG-related antibodies were mainly AChR-Ab and RyR-Ab,while the positive rate of MuSK-Ab and Titin-Ab was relatively low.There was no correlation between AChR-Ab and RyR-Ab with the prognosis of MG.Due to the small sample size of remaining antibodies,it was necessary to expand the sample size for further study.4.Treatment of myasthenia gravis in children with IVIG+ChEI+GC resulted in a higher remission rate. |
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