Thymomatous myasthenia gravis: 10-year experience of a single center

Acta Neurol Scand. 2021 Jan;143(1):96-102. doi: 10.1111/ane.13332. Epub 2020 Sep 6.

Abstract

Objectives: To summarize the clinical features of thymomatous myasthenia gravis (T-MG), examine the association between MG and thymoma, and identify the related factors or predictors for long-term prognosis of T-MG.

Methods: A retrospective, observational study was conducted on 100 patients with T-MG and 96 patients with non-T-MG (NT-MG) between January 1, 2009 and December 31, 2019. The baseline characteristics were recorded for each patient. Logistic regression was used to measure the association between all clinical variables and T-MG prognosis.

Results: Between the T-MG and NT-MG groups, age at onset (45.66 ± 11.53 years vs 39.06 ± 14.39 years); age >40 years (72.0% vs. 40.6%); AChR-Ab positive rate (100.0% vs. 83.3%); Myasthenia Gravis Foundation of America (MGFA) classification at the worst condition (≥grade III, 61.0% vs. 33.0%); thyroid dysfunction (7.0% vs. 20.8%); and outcome (complete stable remission + pharmacologic remission + improvement, 74.0% vs. 93.7%) were statistically significant (P < .05). Presence of thymoma (OR = 0.196, 95%CI = 0.076-0.511, P = .001) was a risk factor for MG. Male sex, post-operative complications, higher grade of MGFA classification, and thymoma Masaoka-Koga pathological stage were risk predictors for long-term prognosis of T-MG (P < .1). Use of preoperative anticholinesterase drugs (OR = 5.504, 95%CI = 1.424-21.284, P = .013) was identified as an independent predictor for T-MG.

Conclusion: T-MG is clinically different from NT-MG, and thymoma is considered a risk factor for MG. Preoperative anticholinesterase drug use is a protective factor for long-term prognosis of T-MG. A comprehensive understanding of the characteristics of T-MG will likely help improve its prognosis.

Keywords: myasthenia gravis; predictors; prognosis; related factor; thymoma.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Cholinesterase Inhibitors / therapeutic use
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myasthenia Gravis / diagnosis*
  • Myasthenia Gravis / epidemiology*
  • Myasthenia Gravis / therapy
  • Retrospective Studies
  • Thymectomy / trends
  • Thymoma / diagnosis*
  • Thymoma / epidemiology*
  • Thymoma / therapy
  • Thymus Neoplasms / diagnosis*
  • Thymus Neoplasms / epidemiology*
  • Thymus Neoplasms / therapy
  • Time Factors

Substances

  • Cholinesterase Inhibitors