title: Increasing incidence of elderly onset patients with myasthenia gravis in a local area of Japan.
abstract: OBJECTIVE
  As the number of elderly patients with myasthenia gravis (MG) has recently increased in Europe and the USA, a retrospective survey of Japanese MG patients was conducted in a single neurological centre over several decades.
  
  
  METHODS
  The study consisted of 112 consecutive MG patients with onset of the disease from 1971 to 2006 from an area of approximately 0.8 million inhabitants in Japan. Patients were classified into three subgroups according to age at onset: young onset (39 years old), middle aged onset (40-59 years old) and elderly onset (60 years old). The trends in incidence rate and clinical features were examined: disease severity, seropositivity for antiacetylcholine receptor antibody, occurrence of other autoimmune diseases, occurrence of thymoma and therapeutic response.
  
  
  RESULTS
  The onset adjusted age specific average annual incidence per 100,000 of the elderly onset MG patients increased 20-fold from 1981-1990 (0.06; 95% CI 0.00 to 0.36) to 2001-2006 (1.30; 95% CI 0.77 to 2.05). Clinical features of the elderly onset MG patients included low antiacetylcholine receptor antibody titres (mean 24.6 nmol/l), less frequent autoimmune overlaps (8.0%) and nearly no complete stable remission with or without thymectomy.
  
  
  CONCLUSIONS
  The increasing incidence of elderly onset MG in Japanese patients similar to that reported in Caucasians has been confirmed. The clinical features suggest different immunological backgrounds between young onset and elderly onset MG patients, irrespective of the ethnic background.
authors.affiliation: Department of Neurology, Institute of Health Bioscience, Tokushima University Graduate School of Medicine, Tokushima, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Matsui
authors.forename: S
authors.initials: S
authors.lastname: Nakane
authors.forename: Y
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: K
authors.initials: K
authors.lastname: Kondo
authors.forename: T
authors.initials: T
authors.lastname: Mitsui
authors.forename: T
authors.initials: T
authors.lastname: Matsumoto
authors.forename: K
authors.initials: K
authors.lastname: Arisawa
authors.forename: R
authors.initials: R
authors.lastname: Kaji
mesh_terms: D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D002391:Catchment Area, Health; D015331:Cohort Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000453:epidemiology*; D012189:Retrospective Studies; D017678:Sex Distribution