Myasthenia gravis and risk factors

Abstract

Myasthenia gravis is a multifactorial disease in the development of which both environmental and genetic factors play an important role. Of the environmental factors influencing the development of myasthenia gravis, the literature describes the characteristics of the microelement composition of soils, water, food, air pollution, and previous infections. However, we did not find data on risk factors for developing the disease, including using the case-control method, in the available literature. The purpose of the study is to determine possible factors influencing the development of myasthenia gravis using the example of the population of the Amur region. An epidemiological study was conducted using the case-control method of 52 patient-control pairs matched by age (± 5 years), gender, and nationality. As of January 1, 2019 in the Amur region, 88 patients with a reliable diagnosis of myasthenia gravis were registered according to diagnostic criteria, of which 26 were men (29.5%) and 62 women (70.5%). As a result of the studies, a positive correlation was established between the prevalence and incidence of myasthenia gravis and the amount of pollutant emissions into the atmosphere. We also noted that the prevalence of myasthenia gravis is higher in areas with lower contents of copper, cobalt, zinc, especially their mobile forms, although we did not find a reliable correlation. Among patients with myasthenia gravis, there was a statistically significant predominance of those born in large families. Patients noted the connection between the onset of the disease or the deterioration of their condition with stress, intercurrent infections, pregnancy and childbirth, surgical interventions, the effects of drugs, and physical activity. A higher risk of developing myasthenia gravis is associated with reasons such as a history of acute stressful situations and past and chronic bacterial infections, especially chronic tonsillitis. The presence of acute stressful situations in the anamnesis as a risk factor for the development of myasthenia gravis suggests the inclusion of psychodiagnostic and psychotherapy methods in the complex of examination, treatment and rehabilitation of patients with myasthenia gravis. Taking into account the possible connection with streptococcal infection, we suggest paying special attention to the concomitant pathology of the ENT organs and promptly treating them with otolaryngologists.