---
title: "Autoimmune Disease Rates in the 10 Years Before Myasthenia Gravis Diagnosis: Nationwide Korean Coh"
id: "pubmed-42555884"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42555884"
content_type: "clinical_feed_article"
specialty: "Neurology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42555884/"
doi: "10.1212/WNL.0000000000218377"
published_at: "2026-09-08T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Autoimmune Disease Rates in the 10 Years Before Myasthenia Gravis Diagnosis: Nationwide Korean Coh
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42555884
- **Specialty:** [Neurology](https://medichelpline.com/clinical-feed/neurology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42555884/)
- **DOI:** [10.1212/WNL.0000000000218377](https://doi.org/10.1212%2FWNL.0000000000218377)
- **Published At:** 2026-09-08T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This retrospective, population-based cohort study used Korean National Health Insurance claims (2010–2021) to evaluate rates and timing of **autoimmune diseases** in the 10 years before a new **myasthenia gravis (MG)** diagnosis. - MG cases (ICD-10 G70.0 plus Rare Intractable Disease registration V012) numbered 8,355 and were matched 1:10 with 83,550 controls by age, sex, and index year; included adults aged ≥20 years. - Outcomes assessed during the 10-year pre-index window were autoimmune thyroid disease (**AITD**), systemic lupus erythematosus (**SLE**), seropositive rheumatoid arthritis (**SRA**), Sjögren syndrome (**SjS**), psoriasis, type 1 diabetes mellitus (**T1DM**), Crohn disease, and ulcerative colitis. - Overall, patients who developed MG had a higher rate of any autoimmune disease in the 10 years before diagnosis compared with controls (rate ratio [RR] 2.12, 95% CI 1.97–2.28). - The association was strongest in the 0–2 years before MG diagnosis (RR 4.27, 95% CI 3.78–4.83), with smaller but elevated RRs in 2–5 and 5–10 year windows (details provided in the report). - Specific autoimmune diseases with the strongest prediagnostic associations were **SLE** (RR 4.87, 95% CI 2.71–8.77), **SjS** (RR 4.75, 95% CI 3.01–7.50), **AITD** (RR 3.66, 95% CI 3.29–4.07), and **SRA** (RR 2.45, 95% CI 1.89–3.19). - **Psoriasis** (RR 1.68, 95% CI 1.25–2.25) and **T1DM** (RR 2.03, 95% CI 1.52–2.71) were associated with MG only in the 0–2 year prediagnostic interval. - Crohn disease and ulcerative colitis showed no association with subsequent MG in the 10 years before diagnosis. - Authors caution interpretation because analyses were based on administrative claims data, which have inherent limitations for diagnostic accuracy and clinical detail.
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Epub 2026 Aug 5. # Rate of Autoimmune Diseases in the 10 Years Preceding Myasthenia Gravis Diagnosis: A Nationwide Cohort Study in South Korea [Soonwook Kwon](https://pubmed.ncbi.nlm.nih.gov/?term=Kwon+S&cauthor_id=42555884)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#full-view-affiliation-1 "Department of Neurology, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea."), [Bong-Seong Kim](https://pubmed.ncbi.nlm.nih.gov/?term=Kim+BS&cauthor_id=42555884)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#full-view-affiliation-2 "Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea."), [Kyungdo Han](https://pubmed.ncbi.nlm.nih.gov/?term=Han+K&cauthor_id=42555884)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#full-view-affiliation-2 "Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea."), [Nam Jin Heo](https://pubmed.ncbi.nlm.nih.gov/?term=Heo+NJ&cauthor_id=42555884)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#full-view-affiliation-3 "Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea."), [Dong Wook Shin](https://pubmed.ncbi.nlm.nih.gov/?term=Shin+DW&cauthor_id=42555884)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#full-view-affiliation-4 "Department of Clinical Research Design and Evaluation/Department of Digital Health, Samsung Advanced Institute of Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#full-view-affiliation-5 "Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea."), [Ju-Hong Min](https://pubmed.ncbi.nlm.nih.gov/?term=Min+JH&cauthor_id=42555884)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#full-view-affiliation-3 "Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#full-view-affiliation-6 "Neuroscience Center, Samsung Medical Center, Seoul, South Korea; and.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#full-view-affiliation-7 "Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea.") Affiliations Expand ### Affiliations * 1 Department of Neurology, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea. * 2 Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea. * 3 Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. * 4 Department of Clinical Research Design and Evaluation/Department of Digital Health, Samsung Advanced Institute of Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea. * 5 Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. * 6 Neuroscience Center, Samsung Medical Center, Seoul, South Korea; and. * 7 Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea. * PMID: **42555884** * DOI: [ 10.1212/WNL.0000000000218377 ](https://doi.org/10.1212/wnl.0000000000218377) Item in Clipboard # Rate of Autoimmune Diseases in the 10 Years Preceding Myasthenia Gravis Diagnosis: A Nationwide Cohort Study in South Korea Soonwook Kwon et al. Neurology. 2026. Show details Display options Display options Format Abstract PubMed PMID Neurology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Neurology%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Neurology%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42555884/) . 2026 Sep 8;107(5):e218377. doi: 10.1212/WNL.0000000000218377. Epub 2026 Aug 5. ### Authors [Soonwook Kwon](https://pubmed.ncbi.nlm.nih.gov/?term=Kwon+S&cauthor_id=42555884)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#short-view-affiliation-1 "Department of Neurology, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea."), [Bong-Seong Kim](https://pubmed.ncbi.nlm.nih.gov/?term=Kim+BS&cauthor_id=42555884)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#short-view-affiliation-2 "Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea."), [Kyungdo Han](https://pubmed.ncbi.nlm.nih.gov/?term=Han+K&cauthor_id=42555884)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#short-view-affiliation-2 "Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea."), [Nam Jin Heo](https://pubmed.ncbi.nlm.nih.gov/?term=Heo+NJ&cauthor_id=42555884)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#short-view-affiliation-3 "Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea."), [Dong Wook Shin](https://pubmed.ncbi.nlm.nih.gov/?term=Shin+DW&cauthor_id=42555884)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#short-view-affiliation-4 "Department of Clinical Research Design and Evaluation/Department of Digital Health, Samsung Advanced Institute of Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#short-view-affiliation-5 "Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea."), [Ju-Hong Min](https://pubmed.ncbi.nlm.nih.gov/?term=Min+JH&cauthor_id=42555884)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#short-view-affiliation-3 "Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#short-view-affiliation-6 "Neuroscience Center, Samsung Medical Center, Seoul, South Korea; and.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42555884/#short-view-affiliation-7 "Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea.") ### Affiliations * 1 Department of Neurology, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea. * 2 Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea. * 3 Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. * 4 Department of Clinical Research Design and Evaluation/Department of Digital Health, Samsung Advanced Institute of Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea. * 5 Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. * 6 Neuroscience Center, Samsung Medical Center, Seoul, South Korea; and. * 7 Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea. * PMID: **42555884** * DOI: [ 10.1212/WNL.0000000000218377 ](https://doi.org/10.1212/wnl.0000000000218377) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background and objectives:** Patients with myasthenia gravis (MG) are frequently associated with other autoimmune diseases. However, the temporal relationship between autoimmune diseases and MG remains unclear. This study aimed to evaluate the rates and temporal patterns of autoimmune diseases during the 10 years preceding MG diagnosis. **Methods:** This retrospective population-based cohort study analyzed claims data from the Korean National Health Insurance Service between 2010 and 2021 and included individuals aged ≥20 years. MG was defined using the International Classification of Diseases, 10th Revision (ICD-10) code (G70.0) and Rare Intractable Disease registration (V012). Each MG case was matched with 10 controls by age, sex, and index year. Outcomes were autoimmune thyroid disease (AITD), systemic lupus erythematosus (SLE), seropositive rheumatoid arthritis (SRA), Sjögren syndrome (SjS), psoriasis, type 1 diabetes mellitus (T1DM), Crohn disease, and ulcerative colitis occurring during the 10 years before the index year. Rate ratios (RRs) and 95% CIs were estimated using Poisson regression models for 0-2, 2-5, and 5-10 years before the index year. **Results:** A total of 8,355 patients with MG and 83,550 matched controls were included. The mean age (SD) was 53.7 (16.0) years, and 44.1% were male. Patients with MG had a higher rate of any autoimmune disease during 10 years before diagnosis than controls (RR 2.12, 95% CI 1.97-2.28), with the highest rates in 0-2 years before diagnosis (RR 4.27, 95% CI 3.78-4.83). SLE (RR 4.87, 95% CI 2.71-8.77), SjS (RR 4.75, 95% CI 3.01-7.50), AITD (RR 3.66, 95% CI 3.29-4.07), and SRA (RR 2.45, 95% CI 1.89-3.19) showed the strongest associations. Psoriasis (RR 1.68, 95% CI 1.25-2.25) and T1DM (RR 2.03, 95% CI 1.52-2.71) were associated with MG only within 0-2 years before diagnosis, whereas Crohn disease and ulcerative colitis were not associated. **Discussion:** Autoimmune diseases were more frequent in the years preceding MG diagnosis than in controls, particularly within 2 years before diagnosis. Strong associations were observed for SLE, SjS, AITD, and SRA. However, these findings should be interpreted with caution because of limitations of administrative claims data. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Incidence, prevalence, and co-occurrence of autoimmune disorders over time and by age, sex, and socioeconomic status: a population-based cohort study of 22 million individuals in the UK. ](https://pubmed.ncbi.nlm.nih.gov/37156255/) Conrad N, Misra S, Verbakel JY, Verbeke G, Molenberghs G, Taylor PN, Mason J, Sattar N, McMurray JJV, McInnes IB, Khunti K, Cambridge G.Conrad N, et al.Lancet. 2023 Jun 3;401(10391):1878-1890. doi: 10.1016/S0140-6736(23)00457-9. Epub 2023 May 5.Lancet. 2023.PMID: 37156255 * [ Risk of incident autoimmune diseases in patients with thymectomy. ](https://pubmed.ncbi.nlm.nih.gov/32478484/) Lin TM, Chang YS, Hou TY, Hsu HC, Lin SH, Chen WS, Kuo PI, Lin YC, Chen JH, Chang CC.Lin TM, et al.Ann Clin Transl Neurol. 2020 Jul;7(7):1072-1082. doi: 10.1002/acn3.51055. Epub 2020 Jun 1.Ann Clin Transl Neurol. 2020.PMID: 32478484Free PMC article. * [ Autoimmune rheumatic diseases increase dementia risk in middle-aged patients: A nationwide cohort study. ](https://pubmed.ncbi.nlm.nih.gov/29304089/) Lin TM, Chen WS, Sheu JJ, Chen YH, Chen JH, Chang CC.Lin TM, et al.PLoS One. 2018 Jan 5;13(1):e0186475. doi: 10.1371/journal.pone.0186475. eCollection 2018.PLoS One. 2018.PMID: 29304089Free PMC article. * [ Myasthenia gravis and five autoimmune diseases: a bidirectional Mendelian randomization study. ](https://pubmed.ncbi.nlm.nih.gov/37910321/) Li K, Ouyang Y, Yang H.Li K, et al.Neurol Sci. 2024 Apr;45(4):1699-1706. doi: 10.1007/s10072-023-07163-3. 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