Incidence of AChR Ab-positive myasthenia gravis in Israel: A population-based study

Background The incidence of myasthenia gravis (MG) has traditionally been low, ranging between 2-6/10(6). Several recent epidemiological studies have reported a higher incidence. We, therefore, aimed to assess and characterize the incidence of MG in Israel. Methods We retrospectively reviewed the records of all four laboratories that performed the acetylcholine receptor antibody (AChR Ab) test in Israel between 1994 and 2013 and documented the number of newly diagnosed seropositive MG patients each year. To assure that data indeed reflect only newly diagnosed patients, patient's names and ID numbers were screened at the Hadassah medical center database since 1978, the year when the test was first performed in Israel. In order to calculate the annual incidence of the disease, the population at risk was derived from the annual publication of the Israeli Central Bureau of Statistics. Results The annual incidence of MG for this time period was 13.1/10(6) inhabitants. The mean incidence of MG between 1994 and 2003 was 7.695/10(6)/y, while the mean incidence between 2004 and 2013 was 18.49/10(6) (P < .0001). Mean age of diagnosis between 1994 and 2003 was 56.65 +/- 0.9351, while between 2004 and 2013, it was 59.89 +/- 0.5336 (P = .0012). Male to female (M:F) incidence ratio in the years 1994-2003 and 2004-2013 was 2:3.2 and 3:1.8, respectively, reflecting increased incidence among males (P < .0001). Conclusions The incidence of MG in Israel has increased significantly during the last decade, especially among males of older age. These findings may reflect an etiological role of an environmental factor, increased awareness, and increased longevity in general.