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Characterization of Patients with Juvenile Myasthenia Gravis from a Reference University Hospital in Colombia

Julissa Andrea Otero Florez, Carolyn Gonzalez Angulo, Jose Leonardo Balmaceda Montejo*, Jose William Cornejo Ochoa, Dagoberto Nicanor Cabrera Hemer

Introduction: Juvenile myasthenia gravis (JGM) is a rare entity, about which there is not enough information. This pathology has its own characteristics and a recognized demographic variability. The consequences of not being diagnosed and treated in time can be serious and its treatment is based on what has been observed in adults.

Objective: To characterize sociodemographically and clinically the population of children diagnosed with MGJ in a reference university hospital in Colombia.

Methodology: Retrospective observational study, in which the medical records of hospitalized patients at the Hospital Universitario San Vicente Fundación (HUSVF) in the city of Medellín, Colombia, from January 2011 to December 2017 were analyzed.

Results: The medical records of 23 patients (14 women) were included. The mean age of onset was 9.1 years. 15 (65.2%) were in the prepubertal period. The type of ocular myasthenia was the most frequent, mainly in prepubertal patients. The myasthenic crisis (MC) occurred in 5 patients (21.7%), predominantly in post pubertal patients. A significant difference was found between the age group and the type of presentation; and a tendency to present psychiatric disorders according to sex and age.

Conclusions: For the authors' knowledge, this is the first characterization study of patients with MGJ in Colombia. The diagnosis was made mainly in prepubertal patients, and the female sex was more affected in both age groups. Similar to what was found in other latitudes, the ocular type appeared more frequently. The proportion of patients with MC was higher than reported. In this study, it was found that belonging to the prepubescent group can increase the risk of presenting MGO. Autoimmune comorbidity was not frequent, and the performance of the different diagnostic aids is good. The guidelines and management lines conform to the recommendations given, however more studies and a sample size of more significant drugs are needed.