Factors predicting remission in thymectomized patients with acetylcholine receptor antibody-positive myasthenia gravis

Muscle Nerve. 2018 Dec;58(6):796-800. doi: 10.1002/mus.26300. Epub 2018 Nov 8.

Abstract

Introduction: Although thymectomy is an important therapeutic option for myasthenia gravis (MG), factors predicting remission after thymectomy are not well known.

Methods: We retrospectively reviewed patients with acetylcholine receptor antibody (AChR-Ab)-positive MG who had undergone thymectomy. Prognostic factors predicting remission were investigated. Changes in AChR-Ab titer before and after thymectomy were also evaluated.

Results: Among the 179 patients, 52.5% achieved complete stable or pharmacologic remission. Nonthymomatous pathology and mild preoperative status were favorable predictors of remission. The decrease in AChR-Ab titer after thymectomy was significant in nonthymomatous MG but not in thymomatous MG.

Discussion: Nonthymomatous pathology and mild preoperative status are prognostic factors that may predict remission after thymectomy. The decrease in AChR-Ab titer after thymectomy was significant in nonthymomatous MG but not in thymomatous MG, suggesting that the pathogenic role of the thymus differs according to pathology. Muscle Nerve 58:796-800, 2018.

Keywords: acetylcholine receptor antibody; myasthenia gravis; prognostic factors; thymectomy; thymic pathology; thymoma.

MeSH terms

  • Adult
  • Aged
  • Autoantibodies / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myasthenia Gravis / blood*
  • Myasthenia Gravis / surgery*
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Receptors, Cholinergic / immunology*
  • Retrospective Studies
  • Thymectomy / methods*
  • Treatment Outcome

Substances

  • Autoantibodies
  • Receptors, Cholinergic