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from Part VIII - Major Human Diseases Past and Present
Published online by Cambridge University Press: 28 March 2008
Myasthenia gravis is a disorder of skeletal muscle characterized by weakness and easy fatigability due to autoimmune destruction of the acetylcholine receptor in the postsynaptic membrane of the neuromuscular junction.
Distribution and Incidence
The disease has a worldwide distribution and has been identified as the primary cause of death at the average annual rate of 1.5 per million in the United States. If cases coded as contributory or as a complication are included, then the total would be 2 to 2.5. This seems to be the safest method of reckoning the actual incidence of myasthenia gravis, and previous estimates of 1 in 1,600 of the population probably vastly overestimate the incidence of myasthenia. There is no difference between whites and non-whites, and there is no difference in nationality. The death rate is slightly higher for women than men. In age-adjusted death rates for all ages, there is no appreciable difference in nine geographic regions of the United States. Thus myasthenia gravis seems to be uniformly distributed throughout the United States, and probably is uniformly distributed throughout the world. There is no difference between city and country in the incidence of myasthenia gravis, and the age-specific death rates for the United States, based on a survey of 675 death certificates listing myasthenia gravis as the primary cause of death, showed that 90 percent of the decedents were older than 15 years of age. For this population the age-specific death rate is less than 1 per million until age 35, when there is a steady increase in the incidence of death for myasthenia gravis up to age 75.
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