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Abstract Details

Myasthenic crisis patient characteristics, readmissions, treatments, and outcomes: A single center analysis
Neuromuscular and Clinical Neurophysiology (EMG)
P6 - Poster Session 6 (5:30 PM-6:30 PM)
11-004

Myasthenic crisis represents a severe worsening of myasthenia gravis resulting in airway compromise requiring ventilatory support. Data regarding factors involved in readmission are limited. 

Evaluate patient characteristics, treatments, outcomes, and readmission data of patients admitted for impending or manifest myasthenic crisis.

We performed a retrospective review of patients admitted with impending or manifest myasthenic crisis to the University of California, Irvine Medical Center between July 2010 and July 2020. Patients were included if they required non-invasive or invasive ventilatory support, or if admitted with concern for progression to respiratory failure. Repeat crisis was determined as a subsequent worsening after clear recovery from the prior crisis event.

58 admissions for myasthenic crisis were identified among 35 patients, allowing for multiple admissions provided they were distinct crisis events. Eight patients (23%) had more than one admission for myasthenic crisis, with a median of 81 days (13 to 2,037) between hospitalizations. Myasthenic crisis hospitalizations occurred an average of 3.8 years following the diagnosis of myasthenia gravis. 29 of 58 admissions occurred three or more years following diagnosis. Median length of hospital stay was 10 days. Patients were treated with plasma exchange (PLEX) in 32 of 58 admissions, intravenous immunoglobulin (IVIg) treatment in 28 of 58 admissions, and two patients were treated with both treatments during the same admission. Two admissions for myasthenic crisis resulted in death, both associated with significant co-morbid conditions.

Repeat hospitalization for myasthenic crisis most often occurred within the first three months following a prior crisis event. Half of all admissions for myasthenic crisis occurred three or more years following the diagnosis of myasthenia gravis. Length of hospitalization for clearly defined myasthenic crisis may be longer than what has been reported by some prior studies. Nearly a quarter of our patients had multiple distinct crises occurring within short intervals. 

Authors/Disclosures
Jeffrey Mullen, MD
PRESENTER
Dr. Mullen has nothing to disclose.
Ali A. Habib, MD (University of California, Irvine) Dr. Habib has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alexion. Dr. Habib has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for argenx. Dr. Habib has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Immunovant. Dr. Habib has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for UCB. Dr. Habib has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pfizer. Dr. Habib has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech/Roche. Dr. Habib has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NMD Pharma. Dr. Habib has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alpine Immune Sciences. Dr. Habib has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH/NINDS. Dr. Habib has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunis Biomedical. Dr. Habib has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffman-La Roche. Dr. Habib has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion. Dr. Habib has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for argenx. Dr. Habib has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for UCB. The institution of Dr. Habib has received research support from Alexion. The institution of Dr. Habib has received research support from VielaBio. The institution of Dr. Habib has received research support from Immunovant. The institution of Dr. Habib has received research support from UCB. The institution of Dr. Habib has received research support from argenx. The institution of Dr. Habib has received research support from CabalettaBio. The institution of Dr. Habib has received research support from Genentech. The institution of Dr. Habib has received research support from Regeneron.