Pulmonary Function Assessment in Myasthenia Gravis Patients in a National Referral Hospital in Indonesia

Fitri Octaviana; Ahmad Yanuar Safri; Winnugroho Wiratman; Luh Ari Indrawati; Nurul Fadli; Manfaluthy Hakim

doi:10.2147/IJGM.S426321

Pulmonary Function Assessment in Myasthenia Gravis Patients in a National Referral Hospital in Indonesia

Int J Gen Med. 2023 Oct 3:16:4477-4483. doi: 10.2147/IJGM.S426321. eCollection 2023.

Authors

Fitri Octaviana^{1

2}, Ahmad Yanuar Safri^{1

2}, Winnugroho Wiratman^{1

2

3}, Luh Ari Indrawati^{1

2}, Nurul Fadli^{1

3}, Manfaluthy Hakim^{1

2}

Affiliations

¹ Department of Neurology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
² Department of Neurology, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
³ Universitas Indonesia Hospital, Depok, Indonesia.

Abstract

Purpose: Myasthenia gravis (MG) can cause respiratory muscle weakness and the need of ventilator support. Spirometry as the gold standard for pulmonary function examination has limited availability, especially in our hospital which is only available in outpatient clinic during work hours (not in emergency room or patient room). Furthermore, all primary healthcare in Indonesia do not have spirometry equipment, thus other alternatives are required. This study aimed to analyze the relationship between a single breath counting test (SBCT), peak flow meter (PFM), and spirometry to assess pulmonary function in MG patients in a national referral hospital in Indonesia.

Patients and methods: A single-center, cross-sectional study was conducted and SBCT, PFM, and spirometry examination were performed in MG patients and healthy controls.

Results: Seventy patients, aged 47.7 ± 13.4 years old, participated in this study. SBCT, forced vital capacity first second (FVC1), and forced expiratory volume first second (FEV1) value between MG patients and healthy controls showed a significant difference, in which healthy controls have higher SBCT, FVC1, and FEV1 values (p = 0.000, p = 0.000 and p = 0.001 respectively). There was a significant difference between PFM with SBCT and FVC1 value in MG patients. Strong correlation was found between SBCT and FVC1 in MG patients.

Conclusion: MG patients had worse pulmonary function compared to healthy controls. SBCT and PFM examination have a significant correlation with FVC1 in MG patients. Therefore, SBCT and PFM can be used as a bedside tool to detect respiratory impairment in MG patients.

Keywords: myasthenia gravis; peak flow meter; single breath counting test; spirometry.

Grants and funding

This research was funded by Cipto Mangunkusumo General Hospital Operational Research Fund year 2019 (Nota Dinas No. LB.03/2.2/7894/2019). The sponsors had no role in the design, execution, interpretation, or writing of the study.