Myasthenia gravis at Ouagadougou (Burkina Faso): about 14 cases

Introduction: Autoimmune myasthenia is a neuromuscular junction disorder that is poorly described in sub-Saharan Africa because of its rarity and difficult diagnosis.Objectives, patients and methodology: We present the socio-demographic, clinical, paraclinical and evolutionary characteristics of a series of 14 patients prospectively collected from March 2012 to January 2017, in Tingandogo University Hospital, Ouagadougou, Burkina Faso.Results: There was a predominance of females (8 females / 6 males), the age at onset of symptoms was between 20 and 40 years for the majority of women and between 40 and 60 years for males.Diagnostic delay was noted with an average delay of 24.73 months.In the initial clinical examination, according to the classification of Myasthenia Gravis Foundation of America, 9 patients (64.3%) were in class IV; Classes II and III were each represented by 2 patients (14.3%), whereas there was only one patient (7.1%) in Class I. Anti-acetylcholine receptor antibodies and Anti-muscle specific kinase antibodies were positive in 6 patients (50%) and 3 patients (25%), respectively.Thymic CT showed a thymic abnormality in 10 patients, including 4 cases of thymoma (28.6%) and 6 cases of thymic hyperplasia (42.8%).Thymectomy was performed in 7 patients (50%), followed by clinical remission in 4 patients (54.1%) and a death in one patient (7.1%). Conclusion:Our results are consistent with those of the literature, except for a low prevalence of anti RACh antibodies and a diagnostic delay at the generalized severe stage.