Japanese Clinical Medicine

The number of patients with late-onset myasthenia gravis (MG) among patients ≥ 50 years has been increasing recently. We encountered three patients who developed elderly-onset MG at a particularly advanced age (≥ 80 years). All were female and positive for anti-acetylcholine receptor antibodies. About 4 years have passed since MG onset in all three patients and symptoms have been controlled without recurrence using a combination of oral low-dose prednisolone and tacrolimus. As many cases of elderly-onset MG do not require strong immunosuppression, we recommend minimum immunosuppressive treatment to avoid adverse events, particularly in patients at an advanced age of ≥ 80 years.