Thymectomy for inducing remission in juvenile myasthenia gravis.
OBJECTIVE
The aim of this study was to determine the efficacy of thymectomy to induce remission in juvenile myasthenia gravis.


METHODS
A retrospective review of all patients undergoing a thymectomy for the treatment of juvenile myasthenia gravis was performed at a single tertiary referral centre between 1997 and 2009 (N = 8). All cases were moderate to severe cases (Osserman stage ≥ 2a). All operations were open. Median follow-up was 18 months (range 1-77). Postoperative progress was assessed using the De Filippi classification of remission.


RESULTS
Only two minor complications were reported. Mean operative time was 120 min (range 80-290 min). Mean postoperative stay was 17 days (range 3-52 days). Remission was observed in 5 of 8 patients (62%) at last known follow up.


CONCLUSIONS
Spontaneous remission rates for myasthenia gravis are quoted to be between 20 and 29% while remission rates following thymectomy are 29-68% at 3 years. Although not all of our patients have had 3 years of follow up-the remission rate of 62% demonstrated by this study is encouraging. If reproducible over a larger series this provides evidence of the efficacy of thymectomy for treating juvenile myasthenia gravis in selected patients.
Alder Hey Children's Hospital, Liverpool, UK. i.hennessey@mac.com
Iain A M
IA
Hennessey
Anna May
AM
Long
Imelda
I
Hughes
Gillian
G
Humphrey
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009157:Myasthenia Gravis / Q000601:surgery*; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D013934:Thymectomy / Q000379:methods*; D016896:Treatment Outcome
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