A new study has determined that moderate or severe anemia is relatively common among female patients with myasthenia gravis (MG). The study, published in PLOS ONE, noted that the long-term immunosuppressive treatment commonly administered to patients with MG is a probable cause of anemia.

“The causes of anemia are complex and diverse, and some of them are drug-related. However, the prevalence and causes of anemia and impact of anemia on the [quality of life] of female MG patients have not been elucidated,” the authors wrote. “The purpose of the present study was to examine the cause of anemia and the negative impact of anemia in female MG patients.”

The research team conducted a retrospective analysis of data on 215 female patients with MG at a single center between January and December 2021. Those patients with hemoglobin levels less than 11 g/dL were considered to have moderate or severe anemia and comprised the anemia group, and the rest of the patients were assigned to the nonanemia group.

The patients’ medical records were reviewed for possible causes and underlying conditions related to anemia. The results showed that 85 (23%) of the included patients had moderate or severe anemia and most of them experienced severe muscle weakness as a result, leading to the need for more intensive immunotherapy.

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In addition, decreased hemoglobin levels were determined to be associated with poorer quality of life, based on the results of the 15-item MG-quality of life scale.

The investigation of possible causes of anemia determined that 32% of patients had no known cause. Those patients with anemia suffered more gynecological and gastrointestinal disorders than those in the nonanemia group, and the research team suspected that these disorders, in addition to long-term immunosuppressive therapy, were likely causes of poor iron metabolism and subsequent anemia. The authors recommend routine monitoring of hemoglobin levels for improved patient management.


Sekiguchi K, Ishizuchi K, Takizawa T, et al. Anemia in female patients with myasthenia gravis. PLOS ONE. 2022;17(9):e0273720. doi:10.1371/journal.pone.0273720