Clinical Course and Serologic Profile of Myasthenia Gravis in a Single-Center Cohort from Western Mexico (2017–2025)
Naomi Becerra Aguiar1, Edson Castro Velazquez2, Enrique Gomez Figueroa3
1Faculty of Medicine, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México., 2Faculty of Medicine, Centro Universitario de Tonala, Universidad de Guadalajara, Tonala, Jalisco, México., 3Neurology Department, Hospital Civil de Guadalajara Fray Antonio Alcalde
Objective:
To describe demographics, clinical severity, serologic profile, thymic pathology, and early generalization in a cohort with Myasthenia Gravis (MG) from Hospital Civil de Guadalajara Fray Antonio Alcale, Mexico.
Background:
MG is a autoimmune disorder of the neuromuscular junction that causes weakness in striated muscles. Data from Latin American public hospitals on MG remain limited, particularly regarding time to generalization and diagnostic pathways.
Design/Methods:
We retrospectively analized adults with MG (January 1, 2017–October 1, 2025). Variables included age, sex, Osserman class, presenting phenotype, generalization (yes/no) with time to generalization (months), Myasthenia Gravis Composite (MGC), Jolly test, AChR/MuSK antibodies, thymoma, and thymectomy. We report medians and proportions, compare generalized vs ocular-only using Mann–Whitney U and Fisher exact tests, and evaluate Osserman class vs generalization.
Results:
We included 53 patients; median age was 53 [34–67] years; 64.2% were women. At presentation, 44/53 were generalized and 9/53 ocular. Out of the 53, 84.9% ever generalized. Time to generalization was rapid: median 1 month [0–2] (n=45). AChR antibodies were positive in 71.8% of those tested (n=39); MuSK positivity was not observed (n=4 tested). Jolly was positive in 55.6% (n=45). Thymoma prevalence (known) was 40.0%; 46.3% underwent thymectomy. Osserman class strongly aligned with generalization: ≥2 vs 1A had markedly higher odds of generalization (Fisher p=9.3×10⁻⁶). Between generalized vs ocular-only groups, we found no statistically significant differences in age (p=0.052), sex (p=0.682), AChR positivity (p=0.655), or Jolly positivity (p=0.684).
Conclusions:
In our cohort, generalization was common and typically rapid, often within the first months of symptom onset. AChR-seropositivity predominated, MuSK testing was infrequent, and thymoma was relatively common. Osserman class remained a strong bedside stratifier for generalization risk. These findings underscore the need for early counseling about generalization, timely immunotherapy optimization, and systematic antibody testing in resource-constrained settings.
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