The impact of thymectomy in subgroups of Myasthenia gravis patients: a single center longitudinal observation

Myasthenia gravis (MG) is a rare neuromuscular disorder. Symptoms can range from ptosis only to life threatening myasthenic crisis. Thymectomy is recommended for anti-acetylcholine receptor-antibody positive patients with early-onset MG. Here, we investigated prognostic factors shaping therapeutic o...

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Bibliographic Details
Published in:Neurological research and practice 2023-06, Vol.5 (1), p.24-24, Article 24
Main Authors: Menghesha, Hruy, Schroeter, Michael, Nelke, Christopher, Ruck, Tobias, Schlachtenberger, Georg, Welskop, Clara, Camo, Amina, Heldwein, Matthias, Bennink, Gerardus, Wahlers, Thorsten, Bölükbas, Servet, Doerr, Fabian, Hekmat, Khosro
Format: Article
Language:English
Subjects:
Activities of daily living
Age
Antibodies
Immunosuppressive agents
Multimodal therapy
Myasthenia gravis
Neuromuscular junctions
Patients
Remission
Thymectomy
Thymoma
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Summary:Myasthenia gravis (MG) is a rare neuromuscular disorder. Symptoms can range from ptosis only to life threatening myasthenic crisis. Thymectomy is recommended for anti-acetylcholine receptor-antibody positive patients with early-onset MG. Here, we investigated prognostic factors shaping therapeutic outcomes of thymectomy to improve patient stratification. We retrospectively collected single-center data from a specialized center for MG from all consecutive adult patients that underwent thymectomy from 01/2012 to 12/2020. We selected patients with thymoma-associated and non-thymomatous MG for further investigations. We analyzed the patient collective regarding perioperative parameters in relation to the surgical approach. Furthermore, we investigated the dynamics of the anti-acetylcholine receptor-antibody titers and concurrent immunosuppressive therapies, as well as the therapeutic outcomes in dependence of clinical classifications. Of 137 patients 94 were included for further analysis. We used a minimally invasive approach in 73 patients, whereas 21 patients underwent sternotomy. A total of 45 patients were classified as early-onset MG (EOMG), 28 as late-onset MG (LOMG) and 21 as thymoma-associated MG (TAMG). The groups differed in terms of age at diagnosis (EOMG: 31.1 ± 12.2 years; LOMG: 59.8 ± 13.7 years; TAMG: 58.6 ± 16.7 years; p 
ISSN:2524-3489
2524-3489
DOI:10.1186/s42466-023-00252-w