Thymectomy and antimuscle antibodies in nonthymomatous myasthenia gravis

Ann N Y Acad Sci. 2003 Sep:998:481-90. doi: 10.1196/annals.1254.062.

Abstract

The clinical effect of thymectomy in early- and late-onset myasthenia gravis (MG) and the correlation to MG severity, pharmacological treatment, and antimuscle antibodies were examined in two series of consecutive acetylcholine receptor (AChR) antibody-positive nonthymoma MG patients. The results indicate a benefit of thymectomy in early-onset MG, but no obvious clinical benefit in late-onset MG. The presence of muscle autoantibodies did not influence the outcome of thymectomy in early-onset MG. In late-onset MG, improvement is least likely in patients with titin and/or RyR antibodies. Thymectomy should always be considered shortly after MG onset in early-onset MG patients and might only be considered in late-onset patients who have early-onset-like immunological characteristics.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adult
  • Age of Onset*
  • Aged
  • Antibodies / metabolism
  • Autoantibodies / blood
  • Blotting, Western
  • Connectin
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Muscle Proteins / immunology
  • Muscle Weakness / etiology
  • Muscle Weakness / immunology
  • Myasthenia Gravis / blood
  • Myasthenia Gravis / complications
  • Myasthenia Gravis / therapy*
  • Protein Kinases / immunology
  • Receptors, Cholinergic / immunology
  • Remission Induction
  • Ryanodine Receptor Calcium Release Channel / immunology
  • Severity of Illness Index
  • Thymectomy*
  • Thymoma / complications
  • Thymoma / surgery
  • Thymoma / therapy
  • Thymus Gland / pathology
  • Thymus Gland / surgery
  • Thymus Neoplasms / complications
  • Thymus Neoplasms / surgery
  • Thymus Neoplasms / therapy
  • Treatment Outcome

Substances

  • Antibodies
  • Autoantibodies
  • Connectin
  • Muscle Proteins
  • Receptors, Cholinergic
  • Ryanodine Receptor Calcium Release Channel
  • TTN protein, human
  • Protein Kinases