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<front>
<journal-meta>
<journal-id journal-id-type="issn">1043-3155</journal-id>
<journal-id journal-id-type="nlm-ta">Pediatr Neurol Briefs</journal-id>
<journal-id journal-id-type="pmc">pedneurbriefs</journal-id>
<journal-id journal-id-type="iso-abbrev">Pediatr Neurol Briefs</journal-id>
<journal-title-group>
<journal-title>Pediatric Neurology Briefs</journal-title>
<abbrev-journal-title>Pediatr Neurol Briefs</abbrev-journal-title>
</journal-title-group>
<issn pub-type="epub">2166-6482</issn>
<issn pub-type="ppub">1043-3155</issn>
<issn-l>2166-3155</issn-l>
<publisher>
<publisher-name>Pediatric Neurology Briefs Publishers</publisher-name>
<publisher-loc>Chicago, IL, USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">PNB-8-60-a</article-id>
<article-id pub-id-type="doi">10.15844/pedneurbriefs-8-8-6</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Myasthenia Gravis</subject>
</subj-group>
<subj-group subj-group-type="Discipline-v2">
<subject>Neurology</subject>
<subject>Pediatrics</subject>
<subject>Nervous System Diseases</subject>
<subject>Child Development</subject>
<subject>Brain Diseases</subject>
<subject>Neurosurgery</subject>
<subject>Child</subject>
<subject>Infant</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Juvenile Myasthenia and Puberty</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-0173-7931</contrib-id>
<name>
<surname>Millichap</surname>
<given-names>J. Gordon</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0001">1</xref>
<xref ref-type="aff" rid="AF0002">2</xref>
<xref ref-type="corresp" rid="cor1">&#x002A;</xref>
</contrib>
</contrib-group>
<aff id="AF0001">
<label>1</label>Division of Neurology, Children&#x0027;s Memorial Hospital, Chicago, IL</aff>
<aff id="AF0002">
<label>2</label>Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL</aff>
<author-notes>
<corresp id="cor1"><label>&#x002A;</label>Correspondence: Dr. J. Gordon Millichap, E-mail: <email xlink:href="jgmillichap@northwestern.edu">jgmillichap@northwestern.edu</email>
</corresp>
</author-notes>
<pub-date date-type="pub" publication-format="print">
<month>08</month>
<year>1994</year>
</pub-date>
<pub-date date-type="pub" publication-format="electronic">
<day>01</day>
<month>06</month>
<year>2016</year>
</pub-date>
<volume>8</volume>
<issue>8</issue>
<fpage>60</fpage>
<lpage>60</lpage>
<permissions>
<copyright-statement>Copyright: &#x00A9; 1994 The Author(s)</copyright-statement>
<copyright-year>1994</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/">
<license-p>This work is licensed under the <uri xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution 4.0 International License</uri>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<related-article id="R1" related-article-type="commentary-article" ext-link-type="doi" xlink:href="10.1212/WNL.44.7.1208" vol="44" page="1208">
<article-title>Race, sex, and puberty influence onset, severity, and outcome in juvenile myasthenia gravis</article-title>
</related-article>
<abstract abstract-type="web-summary" specific-use="electronic-only">
<p>The influence of race, sex, and puberty on incidence, severity, and outcome of juvenile myasthenia gravis beginning before age 20 years was evaluated in 115 patients seen at the University of Virginia, Duke University, and University of North Carolina at Chapel Hill.</p>
</abstract>
<kwd-group>
<kwd>Juvenile Myasthenia</kwd>
<kwd>Puberty</kwd>
<kwd>Thymectomy</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<p>The influence of race, sex, and puberty on incidence, severity, and outcome of juvenile myasthenia gravis beginning before age 20 years was evaluated in 115 patients seen at the University of Virginia, Duke University, and University of North Carolina at Chapel Hill. White patients with prepubertal disease onset had an equal sex ratio, and female predominance increased during and after puberty. Males had less severe disease than females. Black patients showed a constant F:M ratio of 2:1 in all pubertal-onset groups. Spontaneous remissions only occurred in white patients with prepubertal onset; and persistent symptoms for more than 10 years were least frequent in this group. Early thymectomy in white patients was followed by more remissions and milder symptoms than late thymectomy. Black patients had infrequent remissions, and similar disease severity after early or late thymectomy. [<xref ref-type="bibr" rid="CIT0001">1</xref>]</p>
<disp-quote>
<p>COMMENT. This study documents the importance of race, sex, and puberty on the incidence, severity, response to thymectomy, and outcome in juvenile myasthenia gravis. Thymectomy was most effective in white patients when performed within 1 year of peripubertal disease onset. See <underline>Progress in Pediatric Neurology II</underline>, Chicago, PNB Publ, August 1994, for further reports of juvenile myasthenia gravis from the University of Iowa, a multicenter study in Italy, and from the Mass General Hospital, Boston.</p>
</disp-quote>
</body>
<back>
<ref-list>
<ref id="CIT0001">
<label>1</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Andrews</surname>
<given-names>PI</given-names>
</name>
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<given-names>JM</given-names>
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<year>1994</year>
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<volume>44</volume>
<issue>7</issue>
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<pub-id pub-id-type="doi">10.1212/WNL.44.7.1208</pub-id>
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</element-citation>
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</ref-list>
</back>
</article>