title: Myasthenia gravis in Jamaican children: a 12-year institutional review.
abstract: BACKGROUND
  Myasthenia gravis is uncommon in children. The clinical characteristics in children of the English-speaking Caribbean have not been documented previously.
  
  
  OBJECTIVE
  To describe the clinical characteristics and outcome of children with myasthenia gravis at two tertiary hospitals in Jamaica.
  
  
  METHODS
  The case-notes of all children with a diagnosis of myasthenia gravis managed at the University Hospital of the West Indies and Bustamante Hospital for Children between January 1994 and December 2005 were reviewed.
  
  
  RESULTS
  There were 34 children; mean age of onset of illness was 7.5 years and mean period of follow-up was 38.5 months. The male-to-female ratio was 1:1.3. Nineteen (59%) presented with ocular manifestations; 47% of these developed signs of generalised involvement. Most were treated with pyridostigmine and prednisone. Eight patients had thymectomy. Four patients (12%) entered remission. There were two deaths.
  
  
  CONCLUSIONS
  Myasthenia gravis in Jamaican children is similar to that in other populations. It is more common in female children. Most children present with ocular manifestations and remission occurs infrequently.
authors.affiliation: University of the West Indies, Kingston 7, St Andrew, Jamaica. roxanne.melbournechambers@uwimona.edu.jm
authors.forename: R
authors.initials: R
authors.lastname: Melbourne Chambers
authors.forename: S
authors.initials: S
authors.lastname: Forrester
authors.forename: R
authors.initials: R
authors.lastname: Gray
authors.forename: J
authors.initials: J
authors.lastname: Tapper
authors.forename: H
authors.initials: H
authors.lastname: Trotman
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007563:Jamaica; D008297:Male; D009157:Myasthenia Gravis / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery; D011241:Prednisone / Q000627:therapeutic use*; D011379:Prognosis; D011729:Pyridostigmine Bromide / Q000627:therapeutic use*; D013934:Thymectomy; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors; D005938:Glucocorticoids; D011729:Pyridostigmine Bromide; D011241:Prednisone