The primary objectives of the study were to compare iron metabolism patterns between non-anemic immunotherapy-naïve MG patients and healthy controls as well as between the same group of MG patients before and after receiving immunotherapy, and to identify predictors associated with iron metabolism abnormalities in these patients.

Recent evidence has indicated that iron metabolism disorders might be prominent in neuroimmune diseases including multiple sclerosis, polymyositis, dermatomyositis, etc. Nonetheless, few published studies investigated iron metabolism pattern in MG patients and factors associated with it. 

One hundred and five patients and healthy individuals were included at baseline, after which paired parametric and non-parametric tests were adopted to compare their iron metabolism patterns, and multivariate binary logistic regression was used to identify predictors for iron metabolism disorders. MG patients were then followed-up for (12 ± 3) months to explore alterations in their iron metabolism patterns with paired tests.

Non-anemic immunotherapy-naïve MG patients had significantly lower serum iron (SI) and transferrin saturation (TS) levels compared with healthy individuals. Premenopausal female was significantly associated with SI < 65 μg/dL and iron deficiency in these patients. Iron metabolism parameters did not alter significantly after receiving immunotherapy for around 12 months in MG patients.

Iron inadequacy was present in MG patients, particularly premenopausal female ones, and would hardly improve after immunotherapy. Given the essential role of iron in human body, it should be given more attention in MG patients.