What is juvenile myasthenia gravis (MG)?

Updated: Aug 27, 2018
  • Author: Abbas Jowkar, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

It is estimated that approximately 10% of non-neonatal autoimmune MG cases that are acquired will occur before the age of 18 years, and the majority occur subsequent to puberty. The mean age of onset ranges from 7 to 14 years. All features are identical with adult myasthenia gravis, except age. [57]  Children with acquired autoimmune ocular MG are more likely than adults to go into spontaneous remission. Thus, young children with only ocular symptoms of MG can be treated initially with pyridostigmine. Immunotherapy can be initiated if goals of therapy are not met. Children are at particular risk of steroid side effects, including growth failure, poor bone mineralization, and susceptibility to infection, due in part to a delay in live vaccinations. It is recommended that for long-term treatment with corticosteroids use of the lowest effective dose to minimize side effects is acceptable. Maintenance PLEX or IVIg as alternatives to immunosuppressant agents in JMG is also recommended.


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