We present data on the phenotypic variation in myasthenia gravis of 205 subjects from a multi-racial South African cohort. Consecutive subjects seen more than twice from 1996 to 2006, were included. Documented observational data included a myasthenia gravis and extra-ocular eye muscle score. Results showed Black subjects were more likely than Whites to develop treatment-resistant complete ophthalmoplegia and ptosis (18% vs. 2%; p=0.041). Of the 14 patients with this phenotype, 13 had generalised disease and positive AChR antibodies. Despite similar sized cohorts, White subjects were more likely than Blacks to develop generalised myasthenia poorly responsive to therapy (p=0.005). There were no significant racial differences in the time between diagnosis to initiation of therapy, or the performance and timing of thymectomy. The racial variation in some phenotypic features of myasthenia gravis and outcome to therapy, highlights the need to study biological factors in different subgroups to develop a more rational approach to immuno-suppressive therapy.
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机译：我们提出了来自多种族南非队列的205名受试者的重症肌无力的表型变异数据。从1996年到2006年，连续两次被访的受试者都包括在内。记录的观察数据包括重症肌无力和眼外眼肌评分。结果显示，黑人受试者比白人更容易出现对治疗有抵抗力的完全性眼肌麻痹和下垂（18％比2％; p = 0.041）。在14位具有该表型的患者中，有13位患有全身性疾病且AChR抗体阳性。尽管有类似规模的队列研究，但与黑人相比，白人受试者更有可能发展出对治疗反应较差的广义肌无力（p = 0.005）。从诊断到开始治疗之间的时间或胸腺切除术的性能和时机上，种族之间没有显着差异。重症肌无力的某些表型特征和治疗结果的种族差异，凸显了需要研究不同亚组的生物学因素，以开发出更合理的免疫抑制治疗方法。
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