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- Uzawa Akiyuki
- Department of Neurology, Graduate School of Medicine, Chiba University, Japan
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- Suzuki Shigeaki
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, Japan
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- Kuwabara Satoshi
- Department of Neurology, Graduate School of Medicine, Chiba University, Japan
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- Yasuda Manato
- Department of Neurology, Graduate School of Medicine, Chiba University, Japan
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- Akamine Hiroyuki
- Department of Neurology, Graduate School of Medicine, Chiba University, Japan
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- Onishi Yosuke
- Department of Neurology, Graduate School of Medicine, Chiba University, Japan
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- Ozawa Yukiko
- Department of Neurology, Graduate School of Medicine, Chiba University, Japan
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- Kawaguchi Naoki
- Department of Neurology, Neurology Chiba Clinic, Japan
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- Kubota Tomoya
- Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University Graduate School of Medicine, Japan
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- Takahashi Masanori P.
- Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University Graduate School of Medicine, Japan
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- Suzuki Yasushi
- Department of Neurology, National Hospital Organization Sendai Medical Center, Japan
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- Watanabe Genya
- Department of Neurology, National Hospital Organization Sendai Medical Center, Japan
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- Kimura Takashi
- Department of Neurology, Hyogo Medical University, Japan
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- Sugimoto Takamichi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Japan
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- Samukawa Makoto
- Department of Neurology, Kindai University Faculty of Medicine, Japan
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- Minami Naoya
- Department of Neurology, National Hospital Organization Hokkaido Medical Center, Japan
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- Masuda Masayuki
- Department of Neurology, Tokyo Medical University, Japan
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- Konno Shingo
- Department of Neurology, Toho University Ohashi Medical Center, Japan
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- Nagane Yuriko
- Department of Neurology, Hanamaki General Hospital, Japan
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- Utsugisawa Kimiaki
- Department of Neurology, Hanamaki General Hospital, Japan
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Description
<p>Objective Corticosteroids are the primary immunosuppressants used to treat myasthenia gravis (MG). Their side effects, including Cushingoid appearance, are well documented. However, the precise relationship between corticosteroid usage and Cushingoid appearance has not been fully explored. </p><p>Methods This study investigated the frequency and severity of Cushingoid appearance and their relationships with corticosteroid use. In total, 1,321 consecutive patients with MG who were prednisolone users, enrolled in the Japanese MG registry study 2021, were examined, and the severity of Cushingoid appearance was evaluated using the Cushingoid appearance index. </p><p>Results The rates of Cushingoid appearance at survey and peak were 36.4% and 62.0%, respectively. Multivariate regression analyses revealed that the current Cushingoid appearance index was correlated with the current prednisolone dose, duration of prednisolone dose >10 mg/day, and female sex. The risk of Cushingoid appearance was classified according to prednisolone dose and duration using a decision tree. The Cushingoid appearance index significantly decreased with decreases in the prednisolone dose during the 6 years of follow-up. The Cushingoid appearance index was also significantly correlated with the MG-Quality of Life 15-revised score. </p><p>Conclusion This study elucidated the relationship between corticosteroid treatment and Cushingoid appearance in MG, suggesting that the high-dose and long-term use of corticosteroids should be avoided to improve the patient quality of life. </p>
Journal
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- Internal Medicine
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Internal Medicine advpub (0), 2025
The Japanese Society of Internal Medicine