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Neurological Sciences

, Volume 34, Issue 12, pp 2173–2180 | Cite as

The effect of steroid treatment and thymectomy on bone age and height development in juvenile myasthenia gravis

  • Haiyan Wang
  • Zhe Su
  • Chuanming Luo
  • Yan Li
  • Huiyu Feng
  • Wei Fang
  • Chunyan Du
  • Juan Deng
  • Fei Yu
  • Weibin Liu
Original Article

Abstract

Juvenile myasthenia gravis (JMG) is usually associated with growth retardation; however, no data have been published to date in this regard. The goal of this study was to analyze the developmental status of bone age (BA) and height in JMG patients and to subsequently identify the clinical factors, particularly thymectomy, associated with it to guide clinical practice. We conducted a cross-sectional study of 76 JMG patients to examine whether they had abnormalities of height and bone development according to the distribution of the height standard deviation score (Ht SDS) and BA. Correlation analysis and linear regression analysis were conducted to explore the related factors that may affect bone and height development. The mean BA was delayed 0.13 ± 1.42 years compared with the patients’ chronological age (CA). The Ht SDS was also lower than the healthy peers. In multivariate analysis, the age at onset was negatively associated with delayed BA (R 2 = 0.08, p = 0.019), whereas the cumulative intake of prednisone was negatively associated with Ht CASDS (Ht SDS based on CA) (R 2 = 0.168, p = 0.003). There was no significant association between thymectomy and delayed BA and Ht CASDS. Delayed BA and growth retardation existed in JMG patients. The age at onset of JMG was a correlating factor for delayed BA and the cumulative prednisone use may be a determinant of height retardation. Thymectomy had no impact on the growth of bone and height. Monitoring BA and height should become routine care in JMG patients to take appropriate therapeutic interventions.

Keywords

Myasthenia gravis Thymectomy Glucocorticoids Growth Bone age Juvenile 

Abbreviations

MG

Myasthenia gravis

JMG

Juvenile myasthenia gravis

OMG

Ocular myasthenia gravis

GMG

Generalized myasthenia gravis

BA

Bone age

CA

Chronological age

Ht CASDS

Height standard deviations score based on chronological age

Ht BASDS

Height standard deviations score based on bone age

NF-Ht SDS

Near finial height standard deviations score based on adult

BMI SDS

Body mass index standard deviations score based on chronological age

AChR-Ab

Acetylcholine receptor antibody

Notes

Acknowledgments

The study was supported by grants from the National Natural Science Foundation of China (30870850, 81071002), the Clinical study of 5010 plan of Sun Yat-sen University (2010003), and the Postdoctoral Initial Funding of Guangdong province (s2012040006414). The work is attributed to the Department of Neurology, the First Affiliated Hospital, Sun Yat-sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department, National Key Discipline, Guangzhou 510080, China.

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Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  • Haiyan Wang
    • 1
  • Zhe Su
    • 2
  • Chuanming Luo
    • 3
  • Yan Li
    • 1
  • Huiyu Feng
    • 1
  • Wei Fang
    • 4
  • Chunyan Du
    • 5
  • Juan Deng
    • 1
  • Fei Yu
    • 1
  • Weibin Liu
    • 1
  1. 1.Department of NeurologyThe First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina
  2. 2.Department of PediatricsThe First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina
  3. 3.Department of NeurologyThe Second Clinical College of Guangdong Medical CollegeDongguanChina
  4. 4.Department of BiologyLong Island UniversityBrookvilleUSA
  5. 5.Department of Preventive MedicineSchool of Public Health, Sun Yat-sen UniversityGuangzhouChina

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