[Thymectomy and muscle antibodies in myasthenia gravis].
BACKGROUND
Thymectomy as a treatment for myasthenia gravis (MG) is widely carried out as there is good clinical evidence for post-thymectomy improvement in younger MG patients.


METHODS
We examined the relationship between thymectomy, MG severity, the occurrence of muscle autoantibodies against acetylcholine receptor (AChR), titin, and ryanodine receptor (RyR), and pharmacological treatment in 52 early and 43 late-onset MG patients.


CONCLUSIONS
Thymectomy in early-onset MG gave a rapid, highly significant, and long-lasting improvement during the first one to two years after surgery. Several patients had a remission. In late-onset MG, thymectomy did not provide the same improvement, but these patients responded well to immunosuppressive drug treatment, which was necessary in 75% of late-onset MG patients compared to only 25% of early-onset patients. The concentration of AChR, titin, and RyR antibodies did not predict the outcome of thymectomy. The occurrence of titin/RyR antibodies in late-onset MG indicated a less favorable prognosis.
Nevrologisk avdeling, Haukeland Universitetssykehus, 5021 Bergen. fredrik.romi@haukeland.no
Fredrik
F
Romi
Nils Erik
NE
Gilhus
Johan A
JA
Aarli
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000032:analysis*; D064211:Connectin; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009124:Muscle Proteins / Q000276:immunology*; D009157:Myasthenia Gravis / Q000276:immunology / Q000601:surgery*; D011494:Protein Kinases / Q000276:immunology; D011950:Receptors, Cholinergic / Q000276:immunology; D019837:Ryanodine Receptor Calcium Release Channel / Q000276:immunology; D013934:Thymectomy; D016896:Treatment Outcome
D001323:Autoantibodies; D064211:Connectin; D009124:Muscle Proteins; D011950:Receptors, Cholinergic; D019837:Ryanodine Receptor Calcium Release Channel; C577285:TTN protein, human; D011494:Protein Kinases