To study prevalence of OP and Osteopenia for patients with Myasthenia gravis seen in an academic neuromuscular clinic in central Pennsylvania.

Osteoporosis (OP) and Osteopenia are largely under-diagnosed conditions. Scattered reports of prevalence of osteoporosis in patients with neurological disorders have been published. A mouse model study of osteoporosis has shown progressive trabecular bone loss with progression of neuromuscular conditions. Such data for OP and Osteopenia for patients seen in adult Myasthenia patients in the US, are lacking.

In this IRB approved retrospective study, thirty three consecutive adult patients with Myasthenia gravis, diagnosed by serology or SFEMG, after random scheduling, had baseline bone mineral density (BMD) test done from L spine and femur-necks at the onset of diagnosis.  Eighteen were women and fifteen, men.

Five patients had Osteoporosis (15%); twelve had Osteopenia (36%), and sixteen five had normal (49%) BMD testing. Majority (51%) had an abnormal test.7 out of 15 men (47 %( and 10 out of 18 women (55%) had abnormal testing. Results were statistically significant.

This study showed a surprising high prevalence of Osteoporosis and Osteopenia in patients with myasthenia gravis, independent of any known long term similar effects of prednisone therapy.

Large multicenter studies are worth contemplating as this can turn out to be an undiagnosed pandemic. Plummeted quality of life, pain, and fractures can result from osteoporosis, which are potentially preventable if accurate and holistic diagnoses are made in a timely way.