A number of clinical findings can help to identify patients who may develop generalized disease or who may relapse after therapy. These patients may benefit from more aggressive management. The authors are from Beijing Shijitan Hospital and Capital Medical University in Beijing.
Outcomes:
(1) relapse after remission
(2) second generalization disease during the first 6 months after the diagnosis of ocular MG
Criteria for relapse:
(1) reappearance of any symptoms and signs of muscle weakness (extra-ocular, pharyngeal, neck, respiratory, axial muscle, limb muscle)
(2) findings persist > 24 hours
(3) time since last remission > 30 days
Risk factors for relapse:
(1) presence of another autoimmune disease (autoimmune thyroid disease, rheumatoid arthritis, SLE, etc)
Risk factors for generalized disease during the first 6 months after the diagnosis of ocular MG:
(1) single symptom of ptosis or diplopia (versus both)
(2) thymic hyperplasia
(3) older age at disease onset (> 40 years)
