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.
Abstract
BACKGROUND:
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).
METHODS:
We reviewed the clinical information of thymoma-associated MG (TAMG) in 158 patients. Of these, 18 (11%) patients with PostTx MG were identified.
RESULTS:
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.
CONCLUSION:
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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