The impact of HLA on long-term outcome after thymectomy for myasthenia gravis.
In a retrospective series of 86 patients with myasthenia gravis, the only factors predictive of improvement in muscular strength after transsternal thymectomy were preoperative severity of myasthenia (90% versus 54%, p = 0.0014) and HLA-B8 (79% versus 50%, p = 0.0060) in bivariable and multivariable analyses. Both factors were not interrelated (p = 0.824). The statistical effect of HLA-B8 was independent from preoperative severity of disease. Typing for HLA-B8 may thus be a valuable adjunct in predicting the benefit of thymectomy in myasthenia. The observation that an MHC class I allele is associated with clinical improvement after thymectomy suggests that the clinical course of myasthenia may be influenced by class I restricted T-cells.
Machens
A
A
Department of Surgery, University Hospital Eppendorf, Hamburg, Germany. gensurg@medizin.uni-halle.de
Löliger
C
C
Pichlmeier
U
U
Emskötter
T
T
Busch
C
C
Izbicki
J R
JR
D000483:Alleles; D015795:HLA-B8 Antigen / Q000032:analysis / Q000235:genetics / Q000502:physiology*; D006239:Haplotypes; D006801:Humans; D009157:Myasthenia Gravis / Q000276:immunology* / Q000503:physiopathology / Q000601:surgery*; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013934:Thymectomy; D016896:Treatment Outcome
D015795:HLA-B8 Antigen