title: Clinical characteristics of refractory myasthenia gravis patients.
abstract: BACKGROUND
  A subset of myasthenia gravis (MG) patients is refractory to standard therapies. Identifying the characteristics of this population is essential as newer treatment strategies emerge that may be more effective in this group.
  
  
  OBJECTIVE
  The aim of our study is to describe the clinical features of refractory MG patients and compare them to those of non-refractory patients.
  
  
  METHODS
  A retrospective chart review was completed of 128 MG patients referred to a tertiary neuromuscular clinic from 2003 to 2011. Patients were classified as refractory or non-refractory based on predefined criteria, and clinical features were compared.
  
  
  RESULTS
  Nineteen out of 128 patients were classified as refractory (14.8 percent). Compared to the non-refractory patients, the refractory patients were more likely to be younger at onset, female, thymomatous, and MuSK-antibody positive.
  
  
  CONCLUSIONS
  Refractory MG patients represent a small but distinct group for whom exploring newer therapeutic approaches and immunopathologic differences is warranted.
authors.affiliation: Yale School of Medicine, Department of Neurology, Division of Neuromuscular Medicine, New Haven, Connecticut, USA.
authors.forename: Joome
authors.initials: J
authors.lastname: Suh
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Goldstein
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Nowak
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000906:Antibodies / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D009157:Myasthenia Gravis / Q000453:epidemiology / Q000276:immunology / Q000473:pathology*; D013934:Thymectomy; D013945:Thymoma / Q000473:pathology; D055815:Young Adult
chemical_list: D000906:Antibodies
keywords: clinical features; myasthenia gravis; refractory disease