{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:29:02Z","timestamp":1792114142278,"version":"4.4.0"},"reference-count":150,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T00:00:00Z","timestamp":1639958400000},"content-version":"vor","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100012286","name":"Deputy for Research and Technology, Kermanshah University of Medical Sciences","doi-asserted-by":"publisher","award":["4000257"],"award-info":[{"award-number":["4000257"]}],"id":[{"id":"10.13039\/501100012286","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Transl Med"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Myasthenia gravis is a neuromuscular autoimmune disorder characterized by weakness and disability in the voluntary muscles. There have been several preliminary studies on the epidemiology of myasthenia gravis in different parts of the world and the effectiveness of common drugs in its treatment, but there has been no comprehensive study of the efficacy of common drugs in the treatment of myasthenia gravis. Therefore, this study aimed to determine the epidemiology of myasthenia gravis globally and the effectiveness of common drugs in its treatment using systematic review and meta-analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Research studies were extracted from IranDoc, MagIran, IranMedex, SID, ScienceDirect, Web of Sciences (WoS), ProQuest, Medline (PubMed), Scopus and Google Scholar based on Cochran's seven-step guidelines using existing keywords extracted in MeSH browser. The I<jats:sup>2<\/jats:sup>test was used to calculate the heterogeneity of studies, and Begg and Mazumdar rank correlation tests were used to assess publication bias. Data were analyzed using Comprehensive Meta-Analysis software (Version 2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the search for descriptive studies based on the research question, 7374 articles were found. After deleting articles unrelated to the research question, finally, 63 articles with a sample size of 1,206,961,907 people were included in the meta-analysis. The prevalence of MG worldwide was estimated to be 12.4 people (95% CI 10.6\u201314.5) per 100,000 population. For analytical studies on the effectiveness of common myasthenia gravis drugs, 4672 articles were found initially, and after removing articles unrelated to the research question, finally, 20 articles with a sample size of 643 people in the drug group and 619 people in the placebo group were included in the study. As a result of the combination of studies, the difference between the mean QMGS score index after taking Mycophenolate and Immunoglobulin or plasma exchange drugs in the group of patients showed a significant decrease of 1.4\u2009\u00b1\u20090.77 and 0.62\u2009\u00b1\u20090.28, respectively (P\u2009&lt; 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results of systematic review of drug evaluation in patients with myasthenia gravis showed that Mycophenolate and Immunoglobulin or plasma exchange drugs have positive effects in the treatment of MG. It also represents the positive effect of immunoglobulin or plasma exchange on reducing SFEMG index and QMGS index and the positive effect of Mycophenolate in reducing MG-ADL index, SFEMG and Anti-AChR antibodies index. In addition, based on a meta-analysis of the random-effect model, the overall prevalence of MG in the world is 12.4 people per 100,000 population, which indicates the urgent need for attention to this disease for prevention and treatment.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12967-021-03185-7","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T10:03:12Z","timestamp":1639994592000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":95,"title":["Global prevalence of myasthenia gravis and the effectiveness of common drugs in its treatment: a systematic review and meta-analysis"],"prefix":"10.1186","volume":"19","author":[{"given":"Nader","family":"Salari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behnaz","family":"Fatahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yalda","family":"Bartina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsen","family":"Kazeminia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Fatahian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Payam","family":"Mohammadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamarina","family":"Shohaimi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5722-8300","authenticated-orcid":false,"given":"Masoud","family":"Mohammadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,20]]},"reference":[{"issue":"4","key":"3185_CR1","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1212\/WNL.0000000000002790","volume":"87","author":"DB Sanders","year":"2016","unstructured":"Sanders DB, Wolfe GI, Benatar M, Evoli A, Gilhus NE, Illa I, et al. International consensus guidance for management of myasthenia gravis: executive summary. Neurology. 2016;87(4):419\u201325.","journal-title":"Neurology"},{"issue":"10","key":"3185_CR2","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1016\/S1474-4422(15)00145-3","volume":"14","author":"NE Gilhus","year":"2015","unstructured":"Gilhus NE, Verschuuren JJ. Myasthenia gravis: subgroup classification and therapeutic strategies. Lancet Neurol. 2015;14(10):1023\u201336.","journal-title":"Lancet Neurol"},{"key":"3185_CR3","unstructured":"Shield TW, editor. General thoracic surgery, 7th ed. Philadelphia: Wolters Kluwer Health\/Lippincott Williams & Wilkins; 2010. pp. 2323\u201364."},{"issue":"11","key":"3185_CR4","doi-asserted-by":"crossref","first-page":"2843","DOI":"10.1172\/JCI29894","volume":"116","author":"BM Conti-Fine","year":"2006","unstructured":"Conti-Fine BM, Milani M, Kaminski HJ. Myasthenia gravis: past, present, and future. J Clin Invest. 2006;116(11):2843\u201354.","journal-title":"J Clin Invest"},{"issue":"7","key":"3185_CR5","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.nmd.2006.05.006","volume":"16","author":"M Benatar","year":"2006","unstructured":"Benatar M. A systematic review of diagnostic studies in myasthenia gravis. Neuromuscul Disord. 2006;16(7):459\u201367.","journal-title":"Neuromuscul Disord"},{"key":"3185_CR6","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.jaut.2014.01.003","volume":"48\u201349","author":"S Berrih-Aknin","year":"2014","unstructured":"Berrih-Aknin S, Frenkian-Cuvelier M, Eymard B. Diagnostic and clinical classification of autoimmune myasthenia gravis. J Autoimmun. 2014;48\u201349:143\u20138.","journal-title":"J Autoimmun"},{"issue":"5","key":"3185_CR7","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/S1474-4422(09)70063-8","volume":"8","author":"MN Meriggioli","year":"2009","unstructured":"Meriggioli MN, Sanders DB. Autoimmune myasthenia gravis: emerging clinical and biological heterogeneity. Lancet Neurol. 2009;8(5):475\u201390.","journal-title":"Lancet Neurol"},{"issue":"3","key":"3185_CR8","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1038\/85520","volume":"7","author":"W Hoch","year":"2001","unstructured":"Hoch W, McConville J, Helms S, Newsom-Davis J, Melms A, Vincent A. Auto-antibodies to the receptor tyrosine kinase MuSK in patients with myasthenia gravis without acetylcholine receptor antibodies. Nat Med. 2001;7(3):365\u20138.","journal-title":"Nat Med"},{"issue":"2","key":"3185_CR9","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1002\/ana.22312","volume":"69","author":"O Higuchi","year":"2011","unstructured":"Higuchi O, Hamuro J, Motomura M, Yamanashi Y. Autoantibodies to low-density lipoprotein receptor-related protein 4 in myasthenia gravis. Ann Neurol. 2011;69(2):418\u201322.","journal-title":"Ann Neurol"},{"key":"3185_CR10","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1111\/ene.12359","volume":"21","author":"E Kerty","year":"2014","unstructured":"Kerty E, Elsais A, Argov Z, Evoli A, Gilhus NE. EFNS\/ENS guidelines for the treatment of ocular myasthenia. Eur J Neurol. 2014;21:687\u201393.","journal-title":"Eur J Neurol"},{"key":"3185_CR11","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1212\/WNL.0b013e3181ad53c2","volume":"73","author":"AT Heldal","year":"2009","unstructured":"Heldal AT, Owe JF, Gilhus NE, Romi F. Seropositive myasthenia gravis: a nationwide epidemiologic study. Neurology. 2009;73:150\u20131.","journal-title":"Neurology"},{"issue":"11","key":"3185_CR12","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1007\/s00415-017-8616-7","volume":"264","author":"L Wang","year":"2017","unstructured":"Wang L, Zhang S, Xi J, Li W, Zhou L, Lu J, et al. Efficacy and safety of tacrolimus for myasthenia gravis: a systematic review and meta-analysis. J Neurol. 2017;264(11):2191\u2013200.","journal-title":"J Neurol"},{"key":"3185_CR13","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/1471-2377-10-46","volume":"10","author":"AS Carr","year":"2010","unstructured":"Carr AS, Cardwell CR, McCarron PO, McConville J. A systematic review of population-based epidemiological studies in myasthenia Gra-vis. BMC Neurol. 2010;10:46.","journal-title":"BMC Neurol"},{"issue":"Pt 4","key":"3185_CR14","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1093\/brain\/123.4.665","volume":"123","author":"BK MacDonald","year":"2000","unstructured":"MacDonald BK, Cockerell OC, Sander JW, Shorvon SD. The incidence and lifetime prevalence of neurological disorders in a prospective community-based study in the UK. Brain J Neurol. 2000;123(Pt 4):665\u201376.","journal-title":"Brain J Neurol."},{"issue":"1","key":"3185_CR15","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.nmd.2015.10.009","volume":"26","author":"A Breiner","year":"2016","unstructured":"Breiner A, Widdifield J, Katzberg HD, Barnett C, Bril V, Tu K. Epidemiology of myasthenia gravis in Ontario, Canada. Neuromuscular Disord. 2016;26(1):41\u20136.","journal-title":"Neuromuscular Disord"},{"key":"3185_CR16","first-page":"545","volume":"19","author":"JF Kurtzke","year":"1978","unstructured":"Kurtzke JF. Epidemiology of myasthenia gravis. Adv Neurol. 1978;19:545\u201366.","journal-title":"Adv Neurol"},{"issue":"1","key":"3185_CR17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jaut.2007.05.002","volume":"29","author":"WW Eaton","year":"2007","unstructured":"Eaton WW, Rose NR, Kalaydjian A, Pedersen MG, Mortensen PB. Epidemiology of autoimmune diseases in Denmark. J Autoimmun. 2007;29(1):1\u20139.","journal-title":"J Autoimmun"},{"issue":"11","key":"3185_CR18","first-page":"821","volume":"66","author":"H Mh","year":"2009","unstructured":"Mh H, Ms F. The clinical outcome of thymectomy in myasthenia gravis. Tehran Univ Med J TUMS Publications. 2009;66(11):821\u20135.","journal-title":"Tehran Univ Med J TUMS Publications."},{"key":"3185_CR19","doi-asserted-by":"crossref","first-page":"969","DOI":"10.3389\/fphar.2018.00969","volume":"9","author":"S Chen","year":"2018","unstructured":"Chen S, Xu M-B, Zhou X-L, Rong P-Q, Jin T-Y, Zheng G-Q. Chinese herbal medicine for myasthenia gravis: a systematic review and meta-analysis. Front Pharmacol. 2018;9:969.","journal-title":"Front Pharmacol."},{"issue":"4","key":"3185_CR20","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/S1474-4422(16)00032-6","volume":"15","author":"H-F Li","year":"2016","unstructured":"Li H-F, Xie Y, Yue Y-X. Myasthenia gravis: subgroup classifications. Lancet Neurol. 2016;15(4):355\u20136.","journal-title":"Lancet Neurol"},{"key":"3185_CR21","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1196\/annals.1254.064","volume":"998","author":"MN Meriggioli","year":"2003","unstructured":"Meriggioli MN, Rowin J, Richman JG, Leurgans S. Mycophenolate mofetil for myasthenia gravis: a double-blind, placebo-controlled study. Ann NY Acad Sci. 2003;998:494\u20139.","journal-title":"Ann NY Acad Sci"},{"issue":"3","key":"3185_CR22","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1111\/cei.12217","volume":"175","author":"J Sieb","year":"2014","unstructured":"Sieb J. Myasthenia gravis: an update for the clinician. Clin Exp Immunol. 2014;175(3):408\u201318.","journal-title":"Clin Exp Immunol"},{"issue":"1","key":"3185_CR23","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1002\/mus.10133","volume":"26","author":"LG De Feo","year":"2002","unstructured":"De Feo LG, Schottlender J, Martelli NA, Molfino NA. Use of intravenous pulsed cyclophosphamide in severe, generalized myasthenia gravies. Muscle Nerve. 2002;26(1):31\u20136.","journal-title":"Muscle Nerve"},{"issue":"6","key":"3185_CR24","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/j.autrev.2007.01.001","volume":"6","author":"M Garc\u00eda-Carrasco","year":"2007","unstructured":"Garc\u00eda-Carrasco M, Esc\u00e1rcega RO, Fuentes-Alexandro S, Riebeling C, Cervera R. Therapeutic options in autoimmune myasthenia gravis. Autoimmun Rev. 2007;6(6):373\u20138.","journal-title":"Autoimmun Rev"},{"issue":"3-suppl","key":"3185_CR25","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1177\/096120330501400110","volume":"14","author":"E Ciafaloni","year":"2005","unstructured":"Ciafaloni E. Mycophenolate mofetil and myasthenia gravis. Lupus. 2005;14(3-suppl):46\u20139.","journal-title":"Lupus"},{"issue":"7","key":"3185_CR26","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1111\/j.1468-1331.2006.01476.x","volume":"13","author":"GO Skeie","year":"2006","unstructured":"Skeie GO, Apostolski S, Evoli A, et al. Guidelines for the treatment of autoimmune neuromuscular transmission disorders. Eur J Neurol. 2006;13(7):691\u20139.","journal-title":"Eur J Neurol"},{"issue":"9","key":"3185_CR27","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1111\/j.1468-1331.2006.01382.x","volume":"13","author":"C Rozsa","year":"2006","unstructured":"Rozsa C, Lovas G, Fornadi L, Szabo G, Komoly S. Safety of long-term combined immunosuppressive treatment in myasthenia gravis: analysis of adverse effects of 163 patients. Eur J Neurol. 2006;13(9):947\u201352.","journal-title":"Eur J Neurol"},{"key":"3185_CR28","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1196\/annals.1405.033","volume":"1132","author":"DB Drachman","year":"2008","unstructured":"Drachman DB, Adams RN, Hu R, et al. Rebooting the immune system with high-dose cyclophosphamide for the treatment of refractory myasthenia gravis. Ann N Y Acad Sci. 2008;1132:305\u201314.","journal-title":"Ann N Y Acad Sci"},{"issue":"2","key":"3185_CR29","first-page":"255","volume":"86","author":"J Suh","year":"2013","unstructured":"Suh J, Goldstein JM, Nowak RJ. Clinical characteristics of refractory myasthenia gravis patients. Yale J Biol Med. 2013;86(2):255\u201360.","journal-title":"Yale J Biol Med"},{"issue":"11","key":"3185_CR30","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1001\/archneur.62.11.1689","volume":"62","author":"P Gajdos","year":"2005","unstructured":"Gajdos P, Tranchant C, Clair B, Bolgert F, Eymard B, Stojkovic T, et al. Treatment of myasthenia gravis exacerbation with intravenous immunoglobulin: a randomized double-blind clinical trial. Arch Neurol. 2005;62(11):1689\u201393.","journal-title":"Arch Neurol"},{"issue":"23","key":"3185_CR31","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1212\/WNL.0b013e31821e5505","volume":"76","author":"D Barth","year":"2011","unstructured":"Barth D, Nabavi Nouri M, Ng E, Nwe P, Bril V. Comparison of IVIgand PLEX in patients with myasthenia gravis. Neurology. 2011;76(23):2017\u201323.","journal-title":"Neurology"},{"issue":"5","key":"3185_CR32","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1002\/mus.23236","volume":"45","author":"HD Katzberg","year":"2012","unstructured":"Katzberg HD, Barnett C, Bril V. Predictors of response to immunomodulation in patients with myasthenia gravis. Muscle Nerve. 2012;45(5):648\u201352.","journal-title":"Muscle Nerve"},{"issue":"1","key":"3185_CR33","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1007\/s11748-005-1001-y","volume":"53","author":"T Nagayasu","year":"2005","unstructured":"Nagayasu T, Yamayoshi T, Matsumoto K, Ide N, Hasazumi S, Nomura M, et al. Beneficial effects of plasmapheresis before thymectomy on the outcome in myasthenia gravis. Jpn J Thorac Cardiovasc Surg. 2005;53(1):2\u20137.","journal-title":"Jpn J Thorac Cardiovasc Surg"},{"issue":"3","key":"3185_CR34","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1002\/mus.22327","volume":"45","author":"JT Guptill","year":"2012","unstructured":"Guptill JT, Sharma BK, Marano A, Soucy A, Krueger A, Sanders DB. The estimated cost of treating myasthenia gravis in an insured US population. Muscle Nerve. 2012;45(3):363\u20136.","journal-title":"Muscle Nerve"},{"issue":"6","key":"3185_CR35","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1111\/j.1440-1797.2010.01380.x","volume":"15","author":"LK Henderson","year":"2010","unstructured":"Henderson LK, Craig JC, Willis NS, Tovey D, Webster AC. How to write a cochrane systematic review. Nephrology. 2010;15(6):617\u201324.","journal-title":"Nephrology"},{"issue":"5","key":"3185_CR36","doi-asserted-by":"crossref","first-page":"e0176178","DOI":"10.1371\/journal.pone.0176178","volume":"12","author":"J Ramke","year":"2017","unstructured":"Ramke J, Palagyi A, Jordan V, Petkovic J, Gilbert CE. Using the STROBE statement to assess reporting in blindness prevalence surveys in low and middle-income countries. PloS One. 2017;12(5):e0176178.","journal-title":"PloS One."},{"issue":"1","key":"3185_CR37","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/1745-6215-11-32","volume":"11","author":"KF Schulz","year":"2010","unstructured":"Schulz KF, Altman DG, Moher D, Group C. CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Trials. 2010;11(1):32.","journal-title":"Trials"},{"issue":"1\u20132","key":"3185_CR38","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.jns.2011.03.004","volume":"305","author":"H Murai","year":"2011","unstructured":"Murai H, Yamashita N, Watanabe M, Nomura Y, Motomura M, Yoshikawa H, et al. Characteristics of myasthenia gravis according to onset-age: Japanese nationwide survey. J Neurol Sci. 2011;305(1\u20132):97\u2013102.","journal-title":"J Neurol Sci"},{"issue":"2","key":"3185_CR39","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/CND.0000000000000054","volume":"16","author":"AY Nemet","year":"2014","unstructured":"Nemet AY, Kaiserman I, Mimouni M, Segal O, Vinker S. High prevalence of myasthenia gravis among rural adult populations. J Clin Neuromuscul Dis. 2014;16(2):47\u201350.","journal-title":"J Clin Neuromuscul Dis"},{"issue":"3","key":"3185_CR40","doi-asserted-by":"crossref","first-page":"340","DOI":"10.3988\/jcn.2016.12.3.340","volume":"12","author":"S-Y Park","year":"2016","unstructured":"Park S-Y, Lee JY, Lim NG, Hong Y-H. Incidence and prevalence of myasthenia gravis in Korea: a population-based study using the National Health Insurance claims database. J Clin Neurol. 2016;12(3):340\u20134.","journal-title":"J Clin Neurol"},{"issue":"2","key":"3185_CR41","doi-asserted-by":"crossref","first-page":"419","DOI":"10.3349\/ymj.2016.57.2.419","volume":"57","author":"HS Lee","year":"2016","unstructured":"Lee HS, Lee HS, Shin HY, Choi Y-C, Kim SM. The epidemiology of myasthenia gravis in Korea. Yonsei Med J. 2016;57(2):419\u201325.","journal-title":"Yonsei Med J"},{"issue":"Suppl 19","key":"3185_CR42","first-page":"68","volume":"47","author":"S Okinaka","year":"1966","unstructured":"Okinaka S, Reese HH, Katsuki S, et al. The prevalence of multiple sclerosis and other neurological diseases in Japan. Acta Neurologica Scandinavica. 1966;47(Suppl 19):68\u201376.","journal-title":"Acta Neurologica Scandinavica"},{"key":"3185_CR43","first-page":"838","volume":"23","author":"S Araki","year":"1983","unstructured":"Araki S, Uchino M, Yoshida O. Epidemiologic study of multiple sclerosis, myasthenia gravis and polymyositis in the city of Kumamoto, Japan. Clin Neurol. 1983;23:838\u201341.","journal-title":"Clin Neurol"},{"key":"3185_CR44","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1159\/000110138","volume":"7","author":"K Kondo","year":"1988","unstructured":"Kondo K, Takasu T, Ahmed A. Neurological diseases in Karachi, Pakistan\u2014elevated occurrence of subacute sclerosing panencephalitis. Neuroepidemiology. 1988;7:66\u201380.","journal-title":"Neuroepidemiology"},{"issue":"2","key":"3185_CR45","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1111\/j.1600-0404.1992.tb05050.x","volume":"86","author":"YL Yu","year":"1992","unstructured":"Yu YL, Hawkins BR, Ip MS, Wong V, Woo E. Myasthenia gravis in Hong Kong Chinese: epidemiology and adult disease. Acta Neurol Scand. 1992;86(2):113\u20139.","journal-title":"Acta Neurol Scand"},{"issue":"3","key":"3185_CR46","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1111\/ene.13535","volume":"25","author":"A Zieda","year":"2018","unstructured":"Zieda A, Ravina K, Glazere I, Pelcere L, Naudina M, Liepina L, et al. A nationwide epidemiological study of myasthenia gravis in Latvia. Eur J Neurol. 2018;25(3):519\u201326.","journal-title":"Eur J Neurol"},{"issue":"3","key":"3185_CR47","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1159\/000342777","volume":"40","author":"D Lavrnic","year":"2013","unstructured":"Lavrnic D, Basta I, Rakocevic-Stojanovic V, Stevic Z, Peric S, Nikolic A, et al. Epidemiological study of adult-onset myasthenia gravis in the area of Belgrade (Serbia) in the period 1979\u20132008. Neuroepidemiology. 2013;40(3):190\u20134.","journal-title":"Neuroepidemiology"},{"issue":"7","key":"3185_CR48","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1007\/BF00314895","volume":"236","author":"M Tola","year":"1989","unstructured":"Tola M, Granieri E, Paolino E, Caniatti L, Quatrale R, Mazzanti B, et al. Epidemiological study of myasthenia gravis in the province of Ferrara, Italy. J Neurol. 1989;236(7):388\u201390.","journal-title":"J Neurol"},{"issue":"2","key":"3185_CR49","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1159\/000336002","volume":"38","author":"C Montomoli","year":"2012","unstructured":"Montomoli C, Citterio A, Piccolo G, Cioccale R, Ferretti VV, Fratti C, et al. Epidemiology and geographical variation of myasthenia gravis in the province of Pavia, Italy. Neuroepidemiology. 2012;38(2):100\u20135.","journal-title":"Neuroepidemiology"},{"issue":"21\u201322","key":"3185_CR50","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1007\/s00508-012-0258-2","volume":"124","author":"H Cetin","year":"2012","unstructured":"Cetin H, F\u00fcl\u00f6p G, Zach H, Auff E, Zimprich F. Epidemiology of myasthenia gravis in Austria: rising prevalence in an ageing society. Wien Klin Wochenschr. 2012;124(21\u201322):763\u20138.","journal-title":"Wien Klin Wochenschr"},{"issue":"4","key":"3185_CR51","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1111\/j.1600-0404.1984.tb00825.x","volume":"70","author":"A Storm-Mathisen","year":"1984","unstructured":"Storm-Mathisen A. Epidemiology of myasthenia gravis in Norway. Acta Neurol Scand. 1984;70(4):274\u201384.","journal-title":"Acta Neurol Scand"},{"key":"3185_CR52","doi-asserted-by":"crossref","first-page":"e01819","DOI":"10.1002\/brb3.1819","volume":"10","author":"E Westerberg","year":"2020","unstructured":"Westerberg E, Punga AR. Epidemiology of Myasthenia gravis in Sweden 2006\u20132016. Brain Behav. 2020;10:e01819.","journal-title":"Brain Behav"},{"issue":"5","key":"3185_CR53","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1159\/000065639","volume":"21","author":"B Kalb","year":"2002","unstructured":"Kalb B, Matell G, Pirskanen R, Lambe M. Epidemiology of myasthenia gravis: a population-based study in Stockholm, Sweden. Neuroepidemiology. 2002;21(5):221\u20135.","journal-title":"Neuroepidemiology"},{"issue":"4","key":"3185_CR54","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1159\/000109688","volume":"16","author":"I Aiello","year":"1997","unstructured":"Aiello I, Pastorino M, Sotgiu S, Pirastru M, Sau G, Sanna G, et al. Epidemiology of myasthenia gravis in northwestern Sardinia. Neuroepidemiology. 1997;16(4):199\u2013206.","journal-title":"Neuroepidemiology"},{"issue":"4","key":"3185_CR55","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1023\/A:1007449221638","volume":"14","author":"D Guidetti","year":"1998","unstructured":"Guidetti D, Sabadini R, Cavalletti S, Lodesani M, Mantegazza R, Solime FCV. Epidemiological study of myasthenia gravis in the province of Reggio Emilia, Italy. Eur J Epidemiol. 1998;14(4):381\u20137.","journal-title":"Eur J Epidemiol."},{"issue":"11\u201312","key":"3185_CR56","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1007\/s00508-015-0796-5","volume":"127","author":"A Foldvari","year":"2015","unstructured":"Foldvari A, Kovacs N, Sipos V, Merth G, Vincze F, Szucs M, et al. Estimation of incidence, prevalence, and age-at-diagnosis of myasthenia gravis among adults by hospital discharge records. Wien Klin Wochenschr. 2015;127(11\u201312):459\u201364.","journal-title":"Wien Klin Wochenschr"},{"issue":"5","key":"3185_CR57","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1159\/000026179","volume":"17","author":"R Zivadinov","year":"1998","unstructured":"Zivadinov R, Jurjevic A, Willheim K, Cazzato G, Zorzon M. Incidence and prevalence of myasthenia gravis in the County of the Coast and Gorski kotar, Croatia, 1976 through 19961. Neuroepidemiology. 1998;17(5):265\u201372.","journal-title":"Neuroepidemiology"},{"issue":"3\u20134","key":"3185_CR58","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1159\/000477733","volume":"48","author":"M Bettini","year":"2017","unstructured":"Bettini M, Chaves M, Cristiano E, Pagotto V, Perez L, Giunta D, et al. Incidence of autoimmune myasthenia gravis in a health maintenance organization in Buenos Aires, Argentina. Neuroepidemiology. 2017;48(3\u20134):119\u201323.","journal-title":"Neuroepidemiology"},{"key":"3185_CR59","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1111\/ane.12233","volume":"129","author":"J Andersen","year":"2014","unstructured":"Andersen J, Heldal A, Engeland A, Gilhus N. Myasthenia gravis epidemiology in a national cohort; combining multiple disease registries. Acta Neurol Scand. 2014;129:26\u201331.","journal-title":"Acta Neurol Scand"},{"issue":"1","key":"3185_CR60","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.nrleng.2014.09.010","volume":"32","author":"J Aragones","year":"2017","unstructured":"Aragones J, Altimiras J, Roura P, Alonso F, Bufill E, Munmany A, et al. Prevalence of myasthenia gravis in the Catalan county of Osona. Neurolog\u00eda (English Edition). 2017;32(1):1\u20135.","journal-title":"Neurolog\u00eda (English Edition)"},{"key":"3185_CR61","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.jns.2015.11.049","volume":"360","author":"M Salvado","year":"2016","unstructured":"Salvado M, Canela M, Ponseti JM, Lorenzo L, Garcia C, Cazorla S, et al. Study of the prevalence of familial autoimmune myasthenia gravis in a Spanish cohort. J Neurol Sci. 2016;360:110\u20134.","journal-title":"J Neurol Sci"},{"issue":"9","key":"3185_CR62","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1212\/WNL.43.9.1779","volume":"43","author":"P Christensen","year":"1993","unstructured":"Christensen P, Jensen T, Tsiropoulos I, S\u00f8srensen T, Kjser M, H\u00f8jer-Pedersen E, et al. Incidence and prevalence of myasthenia gravis in western Denmark: 1975 to 1989. Neurology. 1993;43(9):1779.","journal-title":"Neurology"},{"issue":"4","key":"3185_CR63","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1136\/jnnp.65.4.492","volume":"65","author":"N Robertson","year":"1998","unstructured":"Robertson N, Deans J, Compston D. Myasthenia gravis: a population-based epidemiological study in Cambridgeshire, England. J Neurol Neurosurg Psychiatry. 1998;65(4):492\u20136.","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"3185_CR64","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1136\/bmj.1.4978.1259","volume":"1","author":"H Garland","year":"1956","unstructured":"Garland H, Clark ANG. Myasthenia gravis, a personal study of 60 cases. BMJ. 1956;1:1259\u201362.","journal-title":"BMJ"},{"key":"3185_CR65","unstructured":"Pennington GW, Wilson A. Incidence of myasthenia gravis in the Merseyside conurbation. In: Veits HR, editor. Myasthenia Gravis. Proceedings of the second international symposium. Springfield IL: Charles C Thomas; 1961; pp. 337\u201345."},{"key":"3185_CR66","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1111\/j.1600-0404.1968.tb07443.x","volume":"44","author":"KR Gudmundsson","year":"1968","unstructured":"Gudmundsson KR. The prevalence of some neurological diseases in Iceland. Acta Neurol Scand. 1968;44:55\u201369.","journal-title":"Acta Neurol Scand"},{"key":"3185_CR67","unstructured":"Oosterhuis: Epidemiologie dei myasthenie in Amsterdam. Neurologie Deutsche Jesells. 1977; 103\u2013108."},{"key":"3185_CR68","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/0022-510X(69)90090-2","volume":"9","author":"E Hokkanen","year":"1969","unstructured":"Hokkanen E. Epidemiology of myasthenia gravis in Finland. J Neurol Sci. 1969;9:463\u201378.","journal-title":"J Neurol Sci."},{"key":"3185_CR69","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/j.1600-0404.1989.tb03793.x","volume":"79","author":"M Giagheddu","year":"1989","unstructured":"Giagheddu M, Puggioni G, Sanna G, et al. Epidemiological study of myasthenia gravis in Sardinia Italy (1958\u20131986). Acta Neurol Scand. 1989;79:326\u201333.","journal-title":"Acta Neurol Scand"},{"issue":"2","key":"3185_CR70","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1111\/j.1600-0404.1991.tb04654.x","volume":"83","author":"R D'Alessamdro","year":"1991","unstructured":"D\u2019Alessamdro R, Granieri E, Benassi G, et al. Comparative study on the prevalence of myasthenia gravis in the provinces of Bologna and Ferrera Italy. Acta Neurol Scand. 1991;83(2):83\u20138.","journal-title":"Acta Neurol Scand"},{"key":"3185_CR71","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1159\/000116405","volume":"29","author":"TT Sorensen","year":"1989","unstructured":"Sorensen TT, Holm EB. Myasthenia gravis in the county of Viborg, Denmark. Eur Neurol. 1989;29:177\u20139.","journal-title":"Eur Neurol"},{"issue":"7","key":"3185_CR72","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1001\/archneur.1991.00530190081019","volume":"48","author":"FE Somnier","year":"1991","unstructured":"Somnier FE, Keiding N, Paulson OB. Epidemiology of myasthenia gravis in Denmark: a longitudinal and comprehensive population survey. Arch Neurol. 1991;48(7):733\u20139.","journal-title":"Arch Neurol"},{"issue":"1","key":"3185_CR73","first-page":"78","volume":"64","author":"PB Christensen","year":"1998","unstructured":"Christensen PB, Jensen TS, Tsiropoulos I, et al. Mortality and survival in myasthenia gravis: a Danish population-based study. JNNP. 1998;64(1):78\u201383.","journal-title":"JNNP"},{"issue":"3","key":"3185_CR74","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1159\/000110923","volume":"11","author":"G Ferrari","year":"1992","unstructured":"Ferrari G, Lovaste MG. Epidemiology of myasthenia gravis in the province of Trento (northern Italy). Neuroepidemiology. 1992;11(3):135\u201342.","journal-title":"Neuroepidemiology"},{"issue":"9","key":"3185_CR75","first-page":"3","volume":"91","author":"ME Krivopusk","year":"1991","unstructured":"Krivopusk ME. Clinico-epidemiological aspects of hereditary neuromuscular diseases in the Krasnodar territory. Zhurnal Nevropatologii I Psikhiatrii Imeni SS Korsakova. 1991;91(9):3\u20135.","journal-title":"Zhurnal Nevropatologii I Psikhiatrii Imeni SS Korsakova"},{"issue":"3","key":"3185_CR76","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1111\/j.1600-0404.1999.tb00733.x","volume":"100","author":"D Lavrnic","year":"1999","unstructured":"Lavrnic D, Jarebinski M, Rakocevic-Stojanovic V, et al. Epidemiological and clinical characteristics of myasthenia gravis in Belgrade, Yugoslavia (1983\u20131992). Acta Neurologica Scandanavica. 1999;100(3):168\u201374.","journal-title":"Acta Neurologica Scandanavica"},{"key":"3185_CR77","unstructured":"Kyriallis K, Hristova A, Middleton I. What is the real epidemiology of myasthenia gravis? Neurology. 1995; A351."},{"issue":"4","key":"3185_CR78","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/S0303-8467(00)00103-7","volume":"102","author":"H Holtsema","year":"2000","unstructured":"Holtsema H, Mourik J, Rico RE, et al. Myasthenia gravis on the Dutch Antilles: an epidemiological study. Clin Neurol Neurosurg. 2000;102(4):195\u20138.","journal-title":"Clin Neurol Neurosurg."},{"issue":"148","key":"3185_CR79","first-page":"2068","volume":"25","author":"A Villagra-Cocco","year":"1997","unstructured":"Villagra-Cocco A, Villagra-Cocco P. Prevalence of myasthenia gravis on the island of La Palma. Revista Neurol. 1997;25(148):2068\u20139.","journal-title":"Revista Neurol"},{"issue":"12","key":"3185_CR80","first-page":"1638","volume":"74","author":"M Oopik","year":"2003","unstructured":"Oopik M, Kaasik AE, Jakobson J. A population-based epidemiological study of myasthenia gravis in Estonia. JNNP. 2003;74(12):1638\u201343.","journal-title":"JNNP"},{"issue":"6","key":"3185_CR81","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1007\/s00415-003-1063-7","volume":"250","author":"PW Wirtz","year":"2003","unstructured":"Wirtz PW, Nijnuis MG, Sotodeh M, et al. The epidemiology of myasthenia gravis, Lambert Eaton myasthenic syndrome and their associated tumours in the northern part of Southern Holland. J Neurol. 2003;250(6):698\u2013701.","journal-title":"J Neurol"},{"issue":"5","key":"3185_CR82","first-page":"52","volume":"106","author":"SV Kotov","year":"2006","unstructured":"Kotov SV, Neretin VI, Agafonov BV, Sidorova OP. Population-based study of Myasthenia in Moscow region. Zhurnal Nevrologii I Psikhiatrii Imeni SS Korsakova. 2006;106(5):52\u20135.","journal-title":"Zhurnal Nevrologii I Psikhiatrii Imeni SS Korsakova"},{"key":"3185_CR83","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1212\/01.wnl.0000176067.32186.a3","volume":"65","author":"FE Somnier","year":"2005","unstructured":"Somnier FE. Increasing incidence of late-onset anti-AChR antibody-seropositive myasthenia gravis. Neurology. 2005;65:928\u201330.","journal-title":"Neurology"},{"issue":"3","key":"3185_CR84","first-page":"352","volume":"71","author":"K Poulas","year":"2001","unstructured":"Poulas K, Tsibri E, Kokla A, et al. Epidemiology of seropositive myasthenia gravis in Greece. JNNP. 2001;71(3):352\u20136.","journal-title":"JNNP"},{"issue":"4","key":"3185_CR85","first-page":"417","volume":"78","author":"EH Niks","year":"2007","unstructured":"Niks EH, Kuks JB, Verschuuren JJ, et al. Epidemiology of myasthenia gravis with anti-muscle specific kinase antibodies in The Netherlands. JNNP. 2007;78(4):417\u20138.","journal-title":"JNNP"},{"issue":"8","key":"3185_CR86","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1111\/j.1468-1331.2009.02624.x","volume":"16","author":"P Tsiamalos","year":"2009","unstructured":"Tsiamalos P, Kordas G, Kokla A, et al. Epidemiological and immunological profile of muscle-specific kinase myasthenia gravis in Greece. Eu J Neurol. 2009;16(8):925\u201330.","journal-title":"Eu J Neurol"},{"issue":"6","key":"3185_CR87","doi-asserted-by":"crossref","first-page":"510","DOI":"10.7727\/wimj.2012.105","volume":"62","author":"J Maharaj","year":"2013","unstructured":"Maharaj J, Bahadursingh S, Ramcharan K. Myasthenia gravis in South Trinidad. West Indian Med J. 2013;62(6):510\u20134.","journal-title":"West Indian Med J"},{"issue":"7","key":"3185_CR88","doi-asserted-by":"crossref","first-page":"A661","DOI":"10.1016\/j.jval.2015.09.2400","volume":"18","author":"B Gordon","year":"2015","unstructured":"Gordon B, Noone J, Van Doren B, Zacherle E, Blanchette C. Prevalence and cost of myasthenia gravis in the medicare beneficiary sample. Value Health. 2015;18(7):A661.","journal-title":"Value Health"},{"issue":"10","key":"3185_CR89","doi-asserted-by":"crossref","first-page":"1888","DOI":"10.1212\/WNL.42.10.1888","volume":"42","author":"LH Phillips","year":"1992","unstructured":"Phillips LH, Torner JC, Anderson MS, Cox GM. The epidemiology of myasthenia gravis in central and western Virginia. Neurology. 1992;42(10):1888.","journal-title":"Neurology"},{"issue":"4","key":"3185_CR90","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/0021-9681(58)90002-X","volume":"8","author":"LT Kurland","year":"1958","unstructured":"Kurland LT. Descriptive epidemiology if selected neurologic and myopathic disorders with particular reference to a survey in Rochester, Minnesota. J Chronic Disorders. 1958;8(4):378.","journal-title":"J Chronic Disorders"},{"key":"3185_CR91","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1001\/archneur.1960.00450040049006","volume":"3","author":"M Alter","year":"1960","unstructured":"Alter M, Rhett-Talbert O, Kurland LT. Myasthenia gravis in a southern community. Arch Neurol. 1960;3:65\u20139.","journal-title":"Arch Neurol"},{"issue":"3","key":"3185_CR92","first-page":"327","volume":"86","author":"NB Kvirkveliia","year":"1986","unstructured":"Kvirkveliia NB. Clinico-epidemiologic aspects of Myasthenia in the Georgian SSR. Zh Nevropatol Psikhiatr Im S S Korsakova. 1986;86(3):327\u201330.","journal-title":"Zh Nevropatol Psikhiatr Im S S Korsakova"},{"issue":"128","key":"3185_CR93","first-page":"435","volume":"24","author":"AD Cisernos","year":"1996","unstructured":"Cisernos AD, Luis RS, Leon R, Carrera PL. Some epidemiological aspects of myasthenia gravis in Cuba. Revista de Neurol. 1996;24(128):435\u20139.","journal-title":"Revista de Neurol"},{"issue":"11","key":"3185_CR94","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.33588\/rn.3411.2001523","volume":"34","author":"JL Sanchez","year":"2002","unstructured":"Sanchez JL, Uribe CS, Franco AF, Jimeniz ME, Arcos-Burgos OM, Palacio LG. Prevalence of myasthenia gravis in Antioquia, Colombia. Revista de Neurologia. 2002;34(11):1010\u20132.","journal-title":"Revista de Neurologia"},{"key":"3185_CR95","unstructured":"Deffeminis Rospide HA, Petra de Mirabel M, Piazza de Silva N, et al. Estudio epidemiologico de la miastenia en el Uruguay. Acta Neurol Latinoamer 1975; 53\u201365."},{"key":"3185_CR96","doi-asserted-by":"crossref","unstructured":"Khedr EM, Fawi G, Abbas MA-A, El-Fetoh AN, Zaki AF, Gamea A, et al. Prevalence of neuromuscular disorders in Qena governorate\/Egypt: a population-based survey. Neurol Res. 2016; 38(12):1056\u201363","DOI":"10.1080\/01616412.2016.1243640"},{"issue":"4","key":"3185_CR97","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1159\/000088674","volume":"25","author":"HN El-Tallawy","year":"2005","unstructured":"El-Tallawy HN, Khedr EM, Qayed MH, Helliwell TR, Kamel NF. Epidemiological study of neuromuscular disorders in Assuit, Egypt. Neuroepidemiology. 2005;25(4):205\u201311.","journal-title":"Neuroepidemiology"},{"issue":"11","key":"3185_CR98","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1111\/j.1468-1331.2012.03698.x","volume":"19","author":"M Gattellari","year":"2012","unstructured":"Gattellari M, Goumas C, Worthington J. A national epidemiological study of myasthenia gravis in Australia. Eur J Neurol. 2012;19(11):1413\u201320.","journal-title":"Eur J Neurol"},{"issue":"6","key":"3185_CR99","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1002\/ana.410410615","volume":"41","author":"P Gajdos","year":"1997","unstructured":"Gajdos P, Chevret S, Clair B, Tranchant C, Chastang C, Group MGCS. Clinical trial of plasma exchange and high-dose intravenous immunoglobulin in myasthenia gravis. Ann Neurol. 1997;41(6):789\u201396.","journal-title":"Ann Neurol"},{"issue":"11","key":"3185_CR100","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1212\/01.wnl.0000256698.69121.45","volume":"68","author":"L Zinman","year":"2007","unstructured":"Zinman L, Ng E, Bril V. IV immunoglobulin in patients with myasthenia gravis: a randomized controlled trial. Neurology. 2007;68(11):837\u201341.","journal-title":"Neurology"},{"issue":"4","key":"3185_CR101","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1002\/mus.10224","volume":"26","author":"GI Wolfe","year":"2002","unstructured":"Wolfe GI, Barohn RJ, Foster BM, Jackson CE, Kissel JT, Day JW, Thornton CA, Nations SP, Bryan WW, Amato AA. Randomized, controlled trial of intravenous immunoglobulin in myasthenia gravis. Muscle Nerve. 2002;26(4):549\u201352.","journal-title":"Muscle Nerve."},{"key":"3185_CR102","doi-asserted-by":"crossref","first-page":"175628641986449","DOI":"10.1177\/1756286419864497","volume":"12","author":"J Gamez","year":"2019","unstructured":"Gamez J, Salvad\u00f3 M, Carmona F, de Nadal M, Romero L, Ruiz D, J\u00e1uregui A, Mart\u00ednez O, P\u00e9rez J, Su\u00f1\u00e9 P. Intravenous immunoglobulin to prevent myasthenic crisis after thymectomy and other procedures can be omitted in patients with well-controlled myasthenia gravis. Ther Adv Neurol Disord. 2019;12:1756286419864497.","journal-title":"Ther Adv Neurol Disord"},{"issue":"5","key":"3185_CR103","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.nmd.2013.02.008","volume":"23","author":"TC Barnett","year":"2013","unstructured":"Barnett TC, Bril V, Davis AM. Performance of individual items of the quantitative myasthenia gravis score. Neuromuscul Disord. 2013;23(5):413\u20137.","journal-title":"Neuromuscul Disord"},{"issue":"1","key":"3185_CR104","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1196\/annals.1405.038","volume":"1132","author":"L Zinman","year":"2008","unstructured":"Zinman L, Bril V. IVIG treatment for myasthenia gravis: effectiveness, limitations, and novel therapeutic strategies. Ann N Y Acad Sci. 2008;1132(1):264\u201370.","journal-title":"Ann N Y Acad Sci"},{"issue":"5","key":"3185_CR105","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1002\/mus.23988","volume":"49","author":"HD Katzberg","year":"2014","unstructured":"Katzberg HD, Barnett C, Merkies IS, Bril V. Minimal clinically important difference in myasthenia gravis: outcomes from a randomized trial. Muscle Nerve. 2014;49(5):661\u20135.","journal-title":"Muscle Nerve"},{"key":"3185_CR106","doi-asserted-by":"crossref","first-page":"175628642091178","DOI":"10.1177\/1756286420911784","volume":"13","author":"S Jacob","year":"2020","unstructured":"Jacob S, Murai H, Utsugisawa K, Nowak RJ, Wiendl H, Fujita KP, O\u2019Brien F, Howard JF Jr. Response to eculizumab in patients with myasthenia gravis recently treated with chronic IVIg: a subgroup analysis of REGAIN and its open-label extension study. Ther Adv Neurol Disord. 2020;13:1756286420911784.","journal-title":"Ther Adv Neurol Disord"},{"issue":"1","key":"3185_CR107","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1196\/annals.1405.001","volume":"1132","author":"P Gajdos","year":"2008","unstructured":"Gajdos P, Chevret S. Treatment of myasthenia gravis acute exacerbations with intravenous immunoglobulin. Ann N Y Acad Sci. 2008;1132(1):271\u20135.","journal-title":"Ann N Y Acad Sci"},{"issue":"23","key":"3185_CR108","doi-asserted-by":"crossref","first-page":"e2661","DOI":"10.1212\/WNL.0000000000007600","volume":"92","author":"JF Howard","year":"2019","unstructured":"Howard JF, Bril V, Burns TM, Mantegazza R, Bilinska M, Szczudlik A, Beydoun S. Garrido FJRDR, Piehl F, Rottoli M: Randomized phase 2 study of FcRn antagonist efgartigimod in generalized myasthenia gravis. Neurology. 2019;92(23):e2661\u201373.","journal-title":"Neurology"},{"issue":"3","key":"3185_CR109","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1002\/mus.24769","volume":"53","author":"M Benatar","year":"2016","unstructured":"Benatar M, Mcdermott MP, Sanders DB, Wolfe GI, Barohn RJ, Nowak RJ, Hehir M, Juel V, Katzberg H, Tawil R. Efficacy of prednisone for the treatment of ocular Myasthenia (EPITOME): a randomized, controlled trial. Muscle Nerve. 2016;53(3):363\u20139.","journal-title":"Muscle Nerve"},{"key":"3185_CR110","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1111\/j.1749-6632.1976.tb47718.x","volume":"274","author":"FM Howard Jr","year":"1976","unstructured":"Howard FM Jr, Duane DD, Lambert EH, Daube JR. Alternate-day prednisone: preliminary report of a double-blind controlled study. Ann N Y Acad Sci. 1976;274:596\u2013607.","journal-title":"Ann N Y Acad Sci"},{"issue":"6","key":"3185_CR111","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1111\/j.1600-0404.1998.tb05968.x","volume":"97","author":"C Lindberg","year":"1998","unstructured":"Lindberg C, Andersen O, Lefvert A. Treatment of myasthenia gravis with methylprednisolone pulse: a double-blind study. Acta Neurol Scand. 1998;97(6):370\u20133.","journal-title":"Acta Neurol Scand"},{"issue":"6","key":"3185_CR112","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1212\/01.wnl.0000312374.95186.cc","volume":"71","author":"D Sanders","year":"2008","unstructured":"Sanders D, Hart I, Mantegazza R, Shukla S, Siddiqi Z, De Baets M, Melms A, Nicolle M, Solomons N, Richman DP. An international, phase III, randomized trial of mycophenolate mofetil in myasthenia gravis. Neurology. 2008;71(6):400\u20136.","journal-title":"Neurology"},{"issue":"5","key":"3185_CR113","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1002\/mus.21142","volume":"38","author":"GI Wolfe","year":"2008","unstructured":"Wolfe GI, Barohn RJ, Sanders DB, McDermott MP. Comparison of outcome measures from a trial of mycophenolate mofetil in myasthenia gravis. Muscle Nerve. 2008;38(5):1429\u201333.","journal-title":"Muscle Nerve"},{"issue":"6","key":"3185_CR114","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1212\/01.wnl.0000312373.67493.7f","volume":"71","author":"MS Group","year":"2008","unstructured":"Group MS. A trial of mycophenolate mofetil with prednisone as initial immunotherapy in myasthenia gravis. Neurology. 2008;71(6):394\u20139.","journal-title":"Neurology"},{"issue":"1","key":"3185_CR115","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1111\/j.1749-6632.2012.06817.x","volume":"1274","author":"S Muppidi","year":"2012","unstructured":"Muppidi S. The myasthenia gravis-specific activities of daily living profile. Ann N Y Acad Sci. 2012;1274(1):114\u20139.","journal-title":"Ann N Y Acad Sci"},{"issue":"5","key":"3185_CR116","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1002\/mus.22140","volume":"44","author":"S Muppidi","year":"2011","unstructured":"Muppidi S, Wolfe GI, Conaway M, Burns TM, Composite M, Group MQS. MG-ADL: still a relevant outcome measure. Muscle Nerve. 2011;44(5):727\u201331.","journal-title":"Muscle Nerve."},{"key":"3185_CR117","unstructured":"Dumitru D, Amato A, Zwarts M, editors. Electrodiagnostic medicine, 2nd ed. Philadelphia: Hanley & belfus, INC, 2002; pp. 1148\u20131177."},{"issue":"1","key":"3185_CR118","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1002\/mus.880120108","volume":"12","author":"JF Jabre","year":"1989","unstructured":"Jabre JF, Chirico-Post J, Weiner M. Stimulation SFEMG in myasthenia gravis. Muscle Nerve. 1989;12(1):38\u201342.","journal-title":"Muscle Nerve"},{"key":"3185_CR119","unstructured":"Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison's principles of internal medicine, 19th ed. New York: McGraw-Hill Education; 2015; pp. 2704\u20136."},{"key":"3185_CR120","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1056\/NEJM198703193161205","volume":"316","author":"RS Tindall","year":"1987","unstructured":"Tindall RS, Rollins JT, Phillips JT, et al. Preliminary results of a double-blind, randomized, placebo-controlled trial of cyclosporine in myasthenia gravis. N Engl J Med. 1987;316:719\u201324.","journal-title":"N Engl J Med"},{"key":"3185_CR121","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1111\/j.1749-6632.1998.tb11015.x","volume":"841","author":"RJ Barohn","year":"1998","unstructured":"Barohn RJ, McIntire D, Herbelin L, et al. Reliability testing of the quantitative myasthenia gravis score. Ann N Y Acad Sci. 1998;841:769\u201372.","journal-title":"Ann N Y Acad Sci."},{"key":"3185_CR122","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1007\/s004150050585","volume":"247","author":"T Sharshar","year":"2000","unstructured":"Sharshar T, Chevret S, Mazighi M, et al. Validity and reliability of two muscle strength scores commonly used as endpoints in assessing treatment of myasthenia gravis. J Neurol. 2000;247:286\u201390.","journal-title":"J Neurol"},{"key":"3185_CR123","doi-asserted-by":"crossref","first-page":"1968","DOI":"10.1212\/01.WNL.0000163988.28892.79","volume":"64","author":"RS Bedlack","year":"2005","unstructured":"Bedlack RS, Simmel D, Bosworth H, et al. Quantitative myasthenia gravis score: assessment of responsiveness and longitudinal validity. Neurology. 2005;64:1968\u201370.","journal-title":"Neurology"},{"key":"3185_CR124","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1097\/WCO.0b013e3283572588","volume":"25","author":"NE Gilhus","year":"2012","unstructured":"Gilhus NE. Myasthenia and neuromuscular junction. Curr Opin Neurol. 2012;25:523\u20139.","journal-title":"Curr Opin Neurol"},{"key":"3185_CR125","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1097\/WCO.0b013e328364c079","volume":"26","author":"L Querol","year":"2013","unstructured":"Querol L, Illa I. Myasthenia and the neuromuscular junction. Curr Opin Neurol. 2013;26:459\u201365.","journal-title":"Curr Opin Neurol"},{"key":"3185_CR126","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1016\/j.autrev.2013.03.001","volume":"12","author":"JJ Verschuuren","year":"2013","unstructured":"Verschuuren JJ, Huijbers MG, Plomp JJ, et al. Pathophysiology of myasthenia gravis with antibodies to the acetylcholine receptor, muscle-specific kinase and low-density lipoprotein receptor-related protein 4. Autoimmun Rev. 2013;12:918\u201323.","journal-title":"Autoimmun Rev"},{"issue":"1","key":"3185_CR127","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1111\/joim.12163","volume":"275","author":"M Huijbers","year":"2014","unstructured":"Huijbers M, Lipka A, Plomp J, Niks E, van der Maarel S, Verschuuren J. Pathogenic immune mechanisms at the neuromuscular synapse: specific antibody-binding epitopes\u2019 role in myasthenia gravis. J Intern Med. 2014;275(1):12\u201326.","journal-title":"J Intern Med"},{"key":"3185_CR128","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/j.autrev.2013.03.002","volume":"12","author":"P Zisimopoulou","year":"2013","unstructured":"Zisimopoulou P, Brenner T, Trakas N, Tzartos SJ. Serological diagnostics in myasthenia gravis based on novel assays and recently identified antigens. Autoimmun Rev. 2013;12:924\u201330.","journal-title":"Autoimmun Rev"},{"key":"3185_CR129","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/B978-0-444-63432-0.00024-4","volume":"133","author":"J Verschuuren","year":"2016","unstructured":"Verschuuren J, Strijbos E, Vincent A. Neuromuscular junction disorders. Handb Clin Neurol. 2016;133:447\u201366.","journal-title":"Handb Clin Neurol"},{"key":"3185_CR130","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1111\/j.1468-1331.2010.03019.x","volume":"17","author":"GO Skeie","year":"2010","unstructured":"Skeie GO, Apostolski S, Evoli A, et al. Guidelines for treatment of autoimmune neuromuscular transmission disorders. Eur J Neurol. 2010;17:893\u2013902.","journal-title":"Eur J Neurol"},{"key":"3185_CR131","first-page":"CD005224","volume":"4","author":"IK Hart","year":"2007","unstructured":"Hart IK, Sathasivam S, Sharshar T. Immunosuppressive agents for myasthenia gravis. Cochrane Database Syst Rev. 2007;4:CD005224.","journal-title":"Cochrane Database Syst Rev"},{"key":"3185_CR132","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1212\/WNL.22.6.603","volume":"22","author":"NG Brunner","year":"1972","unstructured":"Brunner NG, Namba T, Grob D. Corticosteroids in management of severe, generalized myasthenia gravis. Effectiveness and comparison with corticotropin therapy. Neurology. 1972;22:603\u201310.","journal-title":"Neurology"},{"key":"3185_CR133","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1111\/j.1749-6632.1976.tb47719.x","volume":"274","author":"JD Mann","year":"1976","unstructured":"Mann JD, Johns TR, Campa JF, Muller WH. Long-term prednisone followed by thymectomy in myasthenia gravis. Ann NY Acad Sci. 1976;274:608\u201322.","journal-title":"Ann NY Acad Sci"},{"key":"3185_CR134","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1002\/ana.410150316","volume":"15","author":"RM Pascuzzi","year":"1984","unstructured":"Pascuzzi RM, Coslett HB, Johns TR. Long-term cortico- steroid treatment of myasthenia gravis: report of 116 patients. Ann Neurol. 1984;15:291\u20138.","journal-title":"Ann Neurol"},{"key":"3185_CR135","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1159\/000116785","volume":"32","author":"A Evoli","year":"1992","unstructured":"Evoli A, Batocchi AP, Palmisani MT, Monaco ML, Tonali P. Long-term results of corticosteroid therapy in patients with myasthenia gravis. Eur Neurol. 1992;32:37\u201343.","journal-title":"Eur Neurol."},{"key":"3185_CR136","unstructured":"Matell G, Baerendtz S, Hulting J, Malmlund HO. Effects on Myasthenia of twin shock doses of methylprednisolone (TSDMP). 1982. 5th Int Congr Neuromusc Diseases."},{"key":"3185_CR137","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1001\/archneur.1985.04060110031011","volume":"42","author":"E Arsura","year":"1985","unstructured":"Arsura E, Brunner NG, Namba T, Grob D. High-dose intravenous methylprednisolone in myasthenia gravis. Arch Neurol. 1985;42:1149\u201353.","journal-title":"Arch Neurol"},{"issue":"1","key":"3185_CR138","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1212\/WNL.56.1.94","volume":"56","author":"V Chaudhry","year":"2001","unstructured":"Chaudhry V, Cornblath D, Griffin J, O\u2019Brien R, Drachman DB. Mycophenolate mofetil: a safe and promising immunosuppressant in neuromuscular diseases. Neurology. 2001;56(1):94\u20136.","journal-title":"Neurology"},{"issue":"1","key":"3185_CR139","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1212\/WNL.56.1.97","volume":"56","author":"E Ciafaloni","year":"2001","unstructured":"Ciafaloni E, Massey J, Tucker-Lipscomb B, Sanders D. Mycophenolate mofetil for myasthenia gravis: an open-label pilot study. Neurology. 2001;56(1):97\u20139.","journal-title":"Neurology"},{"key":"3185_CR140","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1002\/mus.20030","volume":"29","author":"JC Keesey","year":"2004","unstructured":"Keesey JC. Clinical evaluation and management of myasthenia gravis. Muscle Nerve. 2004;29:484\u2013505.","journal-title":"Muscle Nerve"},{"key":"3185_CR141","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd002275","author":"P Gajdos","year":"2002","unstructured":"Gajdos P, Chevret S, Toyka K. Plasma exchange for myas-thenia gravis. Cochrane Database Syst Rev. 2002. https:\/\/doi.org\/10.1002\/14651858.cd002275.","journal-title":"Cochrane Database Syst Rev"},{"key":"3185_CR142","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1097\/CND.0b013e3181660807","volume":"9","author":"P Jnsen","year":"2008","unstructured":"Jnsen P, Bril V. A comparison of the effectiveness of intravenous immunoglobulin and plasma exchange as preoperative therapy of myasthenia gravis. J Clin NeuromusculDis. 2008;9:352\u20135.","journal-title":"J Clin NeuromusculDis"},{"key":"3185_CR143","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1046\/j.1525-1594.2001.06717.x","volume":"25","author":"J Ronager","year":"2001","unstructured":"Ronager J, Ravnborg M, Hermansen I, Vorstrup S. Immunoglobulintreatment versus plasma exchange in patients with chronic moderate to severe myasthenia gravis. Artif Organs. 2001;25:967\u201373.","journal-title":"Artif Organs"},{"key":"3185_CR144","doi-asserted-by":"crossref","unstructured":"Chegini A. Therapeutic plasmapheresis in myasthenic crisis after botox injection (case report). 2016 (In Persian).","DOI":"10.1016\/j.atherosclerosissup.2017.05.016"},{"key":"3185_CR145","unstructured":"McLeod BC, Weinstein R, Winters JL. Textbook of apheresis principles and practice, 3rd ed. USA: AABB; 2010. pp. 295\u2013317."},{"key":"3185_CR146","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-021-01681-6","author":"G Cellot","year":"2021","unstructured":"Cellot G, Franceschi Biagioni A, Ballerini L. Nanomedicine and graphene-based materials: advanced technologies for potential treatments of diseases in the developing nervous system. Pediatr Res. 2021. https:\/\/doi.org\/10.1038\/s41390-021-01681-6.","journal-title":"Pediatr Res"},{"issue":"4","key":"3185_CR147","doi-asserted-by":"crossref","first-page":"382","DOI":"10.4103\/0972-2327.169535","volume":"18","author":"P Ambesh","year":"2015","unstructured":"Ambesh P, Gregory AD. Nanotechnology in neurology: genesis, current status, and prospects. Ann Indian Acad Neurol. 2015;18(4):382\u20136.","journal-title":"Ann Indian Acad Neurol"},{"issue":"36","key":"3185_CR148","doi-asserted-by":"crossref","first-page":"4154","DOI":"10.2174\/0929867321666140716095644","volume":"21","author":"B Sriramoju","year":"2014","unstructured":"Sriramoju B, Kanwar RK, Kanwar JR. Nanomedicine based nanoparticles for neurological disorders. Curr Med Chem. 2014;21(36):4154\u201368.","journal-title":"Curr Med Chem"},{"issue":"1","key":"3185_CR149","doi-asserted-by":"crossref","first-page":"48","DOI":"10.5582\/ddt.2020.03101","volume":"15","author":"U Kumar Nath","year":"2021","unstructured":"Kumar Nath U, Bhattacharyya D, Chattopadhya D, Dhingra G, Azad SH, Mohanty A. Visceral leishmaniasis masquerading as drug-induced pancytopenia in myasthenia gravis. Drug Discov Therapeutics. 2021;15(1):48\u201350.","journal-title":"Drug Discov Therapeutics"},{"key":"3185_CR150","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1016\/j.biopha.2018.04.126","volume":"103","author":"A Eftekhari","year":"2018","unstructured":"Eftekhari A, Maleki Dizaj S, Chodari L, Sunar S, Hasanzadeh A, Ahmadian E, Hasanzadeh M. The promising future of nano-antioxidant therapy against environmental pollutants induced-toxicities. Biomed Pharmacother. 2018;103:1018\u201327.","journal-title":"Biomed Pharmacother"}],"container-title":["Journal of Translational Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12967-021-03185-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12967-021-03185-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12967-021-03185-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,14]],"date-time":"2024-09-14T19:36:11Z","timestamp":1726342571000},"score":1,"resource":{"primary":{"URL":"https:\/\/translational-medicine.biomedcentral.com\/articles\/10.1186\/s12967-021-03185-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":150,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["3185"],"URL":"https:\/\/doi.org\/10.1186\/s12967-021-03185-7","relation":{},"ISSN":["1479-5876"],"issn-type":[{"value":"1479-5876","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"27 October 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 December 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethics approval was received from the deputy of the research and technology ethics committee, Kermanshah University of Medical Sciences (IR.KUMS.REC.1400.116).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"516"}}