Diversity of childhood-onset myasthenia gravis: pathophysiology and treatment

Myasthenia gravis (MG) is a signaling disorder caused by immune abnormalities at the neuromuscular junction, resulting in symptoms such as muscle weakness and fatigue. Groundbreaking research since the 1970s has revealed the pathophysiology of this disease to be a T cell-dependent, B cell-associated antibody-producing disease. Half a century ago, many patients died of the disease, Today, the mortality rate has declined with many patients achieving remission. Here, I review MG pathophysiology, issues in treatment considerations specific to childhood and adolescence, and examine how racial, cultural, and geographic differences impact the clinical phenotype and treatment practices in childhood-onset MG across East Asia and Western Europe.