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The effectiveness of thymectomy on seronegative generalized myasthenia gravis: comparing with seropositive cases.

AbstractOBJECTIVES:
To investigate the efficacy of thymectomy between patients with seronegative myasthenia gravis (SNMG) and seropositive myasthenia gravis (SPMG).
METHODS:
We present here the first Taiwanese retrospective paired cohort study comparing the effectiveness of thymectomy among 16 seronegative and 32 seropositive MG patients after matching for age-of-onset and time-to-thymectomy, and following up over a mean of 35 +/- 20 (7-86) months. Clinical characteristics and complete stable remission (CSR) rates were compared and analyzed between the groups.
RESULTS:
There were no major clinical differences between the two groups except for our finding of a lower percentage of SNMG receiving preoperative plasmapheresis or human immunoglobulin than SPMG (31% for SNMG vs 72% for SPMG, P = 0.007). CSR rates calculated using the Kaplan-Meier method were similar in the two groups (38% for SNMG vs 50% for SPMG, P = 0.709). The median time for CSR was 47.4 months for SNMG and 48.2 months for SPMG. Thymic hyperplasia were the most common pathology (69% for SNMG vs 88% for SPMG, P = 0.24). During the follow-up period, we found no group difference on prednisolone or pyridostigmine dosages. Significant postoperative dosage reductions on pyridostigmine, but not on prednisolone, were found in both groups.
CONCLUSIONS:
Thymectomy has a comparable response among SNMG and SPMG in our study. Thymic hyperplasia is prevalent in our SNMG patients and thymectomy may also be a therapeutic option to increase the probability of remission or improvement in SNMG. More prospective controlled trial will be helpful in the future.
AuthorsH K Yuan, B-S Huang, S-Y Kung, K-P Kao
JournalActa neurologica Scandinavica (Acta Neurol Scand) Vol. 115 Issue 3 Pg. 181-4 (Mar 2007) ISSN: 0001-6314 [Print] Denmark
PMID17295713 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Antibodies
  • Receptors, Nicotinic
Topics
  • Adult
  • Antibodies (blood)
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Myasthenia Gravis (blood, surgery)
  • Receptors, Nicotinic (immunology)
  • Retrospective Studies
  • Taiwan
  • Thymectomy
  • Treatment Outcome

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