Lu sur : https://www.ncbi.nlm.nih.gov/pubmed/31347231
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Eur J Neurol. 2019 Jul 25. doi: 10.1111/ene.14052. [Epub ahead of print]
Frequency and features of myasthenia gravis developing after thymectomy.
Uzawa A1, Kanai T1, Oda F1, Ozawa Y1, Yasuda M1, Kawaguchi N1,2, Himuro K1, Yoshino I3, Kuwabara S1.
Thymectomy is an effective treatment for myasthenia gravis (MG) with anti-acetylcholine receptor (AChR) antibodies. We rarely encounter patients who develop MG after surgery for thymic tumors. This study aimed to investigate the characteristics and frequency of post-thymectomy onset MG (PostTx MG).
We reviewed the clinical information of thymoma-associated MG (TAMG) in 158 patients. Of these, 18 (11%) patients with PostTx MG were identified.
The presence of anti-AChR antibodies (82%) and electrophysiological abnormalities (50%) was confirmed before thymectomy in patients with PostTx MG. The clinical characteristics of PostTx MG were similar to pre-thymectomy onset MG (PreTx MG). In PostTx MG, the duration between thymectomy and MG onset were distributed as <6 months (early-onset PostTx MG) and ≥6 months (late-onset PostTx MG). Notably, some patients with late-onset PostTx MG were associated with thymoma relapse.
Our results suggest that approximately 11% of patients with TAMG were PostTx MG, and presurgical assessment of anti-AChR antibody titer or electrophysiological testing may predict PostTx MG development; however, no difference in clinical manifestation and prognosis is observed between PreTx MG and PostTx MG. T
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