Investigation of Independent Risk Factors for Recurrent Infection in Myasthenia Gravis Patients

The following is a summary of “Myasthenia gravis and independent risk factors for recurrent infection: a retrospective cohort study,” published in the July 2023 issue of Neurology by Chien et al.

Myasthenic crisis (MC), a life-threatening complication of myasthenia gravis (MG), affects approximately 10% to 20% of MG patients. MC is associated with poor outcomes, mainly when triggered by infection.

Researchers performed a retrospective study to identify clinical symptoms, underlying health conditions, and biochemical markers associated with recurrent MC in MG patients. In this retrospective study of 272 MG patients with infection requiring at least 3 days of antibiotics from January 2001 to December 2019. Patients were categorized into non-recurrent or recurrent infection groups. Study recorded various clinical features (e.g., gender, age, concomitant diseases), laboratory data (e.g., electrolytes, coagulation parameters), muscle strength assessment, bulbar and respiratory function, management methods (e.g., endotracheal tube, Foley catheter, plasmapheresis), duration of hospitalization, and cultured pathogens. Recurrent infections were more common in older patients(median age, 58.5 versus 52.0 years), patients with diabetes mellitus, activated partial thromboplastin time prolongation, a longer duration of hospitalization, and hypomagnesemia were at an increased risk of recurrent infection. Patients with deep vein thrombosis, thymic cancer, and electrolyte imbalances, i.e., hypokalemia and hypoalbuminemia, were also at an increased risk of infection. However, the influence of endotracheal intubation, anemia, and plasmapheresis during hospitalization was inconsistent.

Study found 4 risk factors for recurrent infections in MG patients: diabetes, hypomagnesemia, and longer hospitalization. These findings highlight the need for targeted interventions to prevent recurrent infections. Further research and prospective studies are warranted to validate these findings and refine interventions.

Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-023-03306-3