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Impact of autoimmune comorbidity on fatigue, sleepiness and mood in myasthenia gravis

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Abstract

Background

Disease burden in myasthenia gravis (MG) and in other autoimmune disorders is often determined by common accompanying symptoms such as fatigue, sleepiness and mood disturbances. Many MG patients have a second autoimmune disease, but it is unclear whether autoimmune comorbidities add to the severity of fatigue, sleepiness and mood disturbances.

Methods

We ascertained the presence of autoimmune comorbidities in 69 well-characterized MG patients. To assess fatigue, sleepiness and mood disturbances, we applied the Fatigue Severity Scale (FSS), the Fatigue Impact Scale (FIS), the Epworth Sleepiness Scale (ESS), as well as the Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) to all patients.

Results

Thirteen MG patients had concomitant autoimmune thyroid disease (AITD), including 1 patient with rheumatoid arthritis as third autoimmune disease. Fatigue (68.1%), excessive daytime sleepiness (14.5%), moderate-severe depression (20.3%) and anxiety (26.1%) were common, but MG patients with and without autoimmune comorbidities had similar FSS, FIS, ESS, BDI and STAI scores. The presence of autoimmune comorbidities was not associated with altered clinical and immunological MG characteristics, but MG patients with autoimmune comorbidities have more often been treated with corticosteroids than patients without autoimmune comorbidities (92.3% vs. 60.7%; p = 0.03).

Conclusions

While many MG patients were affected by fatigue, sleepiness, depression and anxiety, the present study does not suggest that coexisting autoimmune diseases substantially contribute to the magnitude of these cumbersome comorbid symptoms. However, the higher frequency of steroid treatment may have counterbalanced the effects of the autoimmune comorbidity.

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Author information

Authors and Affiliations

  1. Department of Neurology and Psychiatry, Almazov National Medical Research Centre, 197341, St. Petersburg, Russia

    T. M. Alekseeva

  2. Department of Neurology, North-Western State Medical University, 191015, St. Petersburg, Russia

    O. A. Kreis

  3. Department of General Pathology and Pathological Physiology, Institute of Experimental Medicine, St. Petersburg, Russia

    Y. V. Gavrilov

  4. Department of Neurology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland

    P. O. Valko, K. P. Weber & Yulia Valko

  5. Department of Ophthalmology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland

    K. P. Weber

Authors
  1. T. M. Alekseeva
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  2. O. A. Kreis
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  3. Y. V. Gavrilov
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  4. P. O. Valko
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  5. K. P. Weber
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  6. Yulia Valko
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Correspondence to Yulia Valko.

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Alekseeva, T.M., Kreis, O.A., Gavrilov, Y.V. et al. Impact of autoimmune comorbidity on fatigue, sleepiness and mood in myasthenia gravis. J Neurol 266, 2027–2034 (2019). https://doi.org/10.1007/s00415-019-09374-1

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  • DOI: https://doi.org/10.1007/s00415-019-09374-1

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