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- Ramanujam, R, et al.
(författare)
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Utilizing twins concordance rates to infer the predisposition to myasthenia gravis
- 2011
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Ingår i: Twin research and human genetics : the official journal of the International Society for Twin Studies. - : Cambridge University Press (CUP). - 1832-4274. ; 14:2, s. 129-136
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Tidskriftsartikel (refereegranskat)abstract
- Myasthenia gravis (MG) is an autoimmune disorder in which patients experience muscular fatigability due to the presence of anti-acetylcholine receptor (AChR) antibodies which inhibit signal transduction across the neuro-muscular junction. Like all complex disorders, disease is caused by an interaction between genetic and environmental factors. Although several genes have been identified which appear to be associated with MG, both classic twin studies and current multi-gene models are insufficient to explain either disease pathogenesis or inheritance. We examined the literature on MG to determine both mono- and dizygotic twin concordance rates, and used this data to (1) estimate the proportion of the population with underlying genetic predisposition to MG and the frequency of the environmental component and (2) derive the number of inherited genetic regions that are required to confer predisposition to MG. Using a MZ twin concordance rate of 35.5%, and a dizygotic rate of approximately 4–5% (based on family data), the probability of encountering environmental components necessary to develop MG in an individual with genetic predisposition is approximately 52.4%, making the frequency of predisposition (1:5240) roughly twice the rate of incidence. Furthermore, the number of genetic regions co-inherited between affected individuals is between two and four, which may be large haplotypes with interacting activity. Determining these haplotypes, by fully sequencing associated regions in cases and controls to identify mutations present, may therefore be a practically step toward the understanding of complex disease.
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- Kalb, B, et al.
(författare)
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Epidemiology of myasthenia gravis: a population-based study in Stockholm, Sweden
- 2002
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Ingår i: Neuroepidemiology. - : S. Karger AG. - 0251-5350 .- 1423-0208. ; 21:5, s. 221-225
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Tidskriftsartikel (refereegranskat)abstract
- A regional database of myasthenia gravis (MG) patients was used to estimate the prevalence and selected characteristics of the disease in the county of Stockholm, Sweden. The prevalence of MG was 14.1/100,000 (17.1 for women and 10.8 for men). The mean age at onset for women and men was 34.9 and 48.5 years, respectively. About 60% of patients were diagnosed within the first year after initial symptoms. Generalized MG was found in 79% of patients, and 10% had severe symptoms. Almost two thirds of the patients had undergone thymectomy, and 30% needed immunosuppressive treatment. The increase in the prevalence of MG since the 1960s probably reflects an improvement in prognosis and higher detection rates of patients with milder symptoms. A delay in diagnosis indicates that early signs and symptoms of MG are still not well known by all doctors.
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