Journal
NEUROEPIDEMIOLOGY
Volume 44, Issue 4, Pages 221-231Publisher
KARGER
DOI: 10.1159/000431036
Keywords
Myasthenia gravis, prevalence; Muscle specific tyrosine kinase antibody; Acetylcholine receptor antibody; Late-onset myasthenia gravis; Phenotype
Funding
- FIGHT-MG EU FP7 frame program [242210]
- Euromyasthenia EU FP7 [2005105]
- Unifor.no
- Wilhelmsen's foundation
- Princes Beatrix foundation
- Association Francaise contre les Myopathies
- Valsoe's foundation
- Norwegian association for patients with muscle disease
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Objectives: To compare the prevalence of myasthenia gravis (MG) subgroups based on immunological markers and clinical presentation in two geographically complete MG populations in northern Europe. Methods:This cross-sectional study included all living MG patients in Norway and a regional cohort from the Netherlands. Patients were identified using their hospital registration codes. Medical charts of subjects >16 years were reviewed. Inclusion criteria were clinical MG, a positive antibody test for acetylcholine receptor (AChR MG) or muscle-specific kinase (MuSK MG), or if seronegative MG, confirmed by an electrophysiological test. Results: 1,205 MG patients (534 Norwegians and 671 Dutch) fulfilled the criteria, giving a higher point prevalence in the Netherlands (167/million, 95% CI 155-180) than in Norway (138/million, 95% CI 126-150). In particular, rates of AChR MG (143 vs. 111/million), MuSK MG (6.5 vs. 0.5/million), and ocular phenotype (62 vs. 24/million) were higher in the Netherlands. Conclusion: Novel findings are an AChR MG geographical north south gradient and a 2.6-fold more ocular MG patients in the Netherlands than in Norway. The MuSK MG latitudinal gradient supports the notion of a north south gradient in Europe, with a higher prevalence in the south. The variation is probably explained by genetic differences between the populations, in addition to environmental interactions. (C) 2015 S. Karger AG, Basel
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