Content area
Abstract
In determining the cause of death, the investigators have relied on death certificate descriptions; what remains unclear is how reliable these entries were, especially when issued in the peripheral hospitals by non-neurologist doctors. Over the years, additional benefits have accrued from the introduction of immunosuppressants, plasma exchange, immunoglobulins and also general advances in intensive care, ventilatory support and newer antibiotic therapies. Since this cohort was exposed significantly less to immunosuppressants,[4] it follows that introduction of steroid sparing agents (like azathioprine) may have further improved mortality. [4] Indeed, the authors find that addition of immunosuppressants (only azathioprine and FK 506 were used) results in a highly significant protection from death in male patients with MG (it remains puzzling why this effect was not seen in female patients in this population?). Department of Neurology, Institute of Brain, Behaviour and Mental Health, University of Manchester, UK; Department of Neurology, Santokba Durlabhji Memorial Hospital...