Analysis of prognostic factors in thymectomized patients with myasthenia gravis: correlation between thymic lymphoid cell subsets and postoperative clinical course.
We retrospectively examined the postoperative clinical course of 50 consecutive patients with myasthenia gravis who underwent a transsternal extended thymectomy. Twenty-six patients (52%) showed a steady improving postoperative course without any additional immunotherapy (group A). The remaining 24 patients (48%) had an intractable postoperative course, and most of them needed additional immunotherapy (group B). A significant increases in CD3+ cells, HLA-DR+ cells and B-cells and significant decreases in CD1+ cells and CD8+ cells were observed in the thymuses from patients in group B, compared with the findings in group A. In the peripheral blood, the ratio of CD4+ cells to CD8+ cells was significantly increased in group B. Patients who were either under 40 years of age, females, or without thymoma had good clinical courses after the thymectomy alone.
Fujii
N
N
Department of Neurology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Itoyama
Y
Y
Machi
M
M
Goto
I
I
D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D018949:Antigens, CD1; D000945:Antigens, Differentiation, T-Lymphocyte / Q000032:analysis; D017252:CD3 Complex; D016516:CD4-CD8 Ratio; D016827:CD8 Antigens / Q000032:analysis; D005260:Female; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D007167:Immunotherapy; D008297:Male; D009157:Myasthenia Gravis / Q000276:immunology* / Q000601:surgery*; D011379:Prognosis; D011948:Receptors, Antigen, T-Cell / Q000032:analysis; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D013934:Thymectomy; D013950:Thymus Gland / Q000276:immunology*; D016896:Treatment Outcome
D015703:Antigens, CD; D018949:Antigens, CD1; D000945:Antigens, Differentiation, T-Lymphocyte; D017252:CD3 Complex; D016827:CD8 Antigens; D006684:HLA-DR Antigens; D011948:Receptors, Antigen, T-Cell