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Objective: Seropositive myasthenia gravis (MG) depends on the presence of acetylcholine receptor antibodies (AchR-Ab) against nicotinic acetylcholine receptors at the postsynaptic neuromuscular junction. In this study, we investigated the effect of AchR-Ab levels to symptoms and treatment in the MG patients underwent surgery for thymic pathology. Materilas and Methods: The records including level of preoperative AchR-Ab, type of thymic pathology, the changes of symptoms and treatment after surgery for thymic pathology of 37 MG patients between January 2007 and December 2015 have been viewed retrospectively. Results: The mean age of 37 patients (21 females, 16 males) was 40.2 ± 14.9 years (range, 18 to 75 years). The mean of the level of AchR-Ab was 144.7 ± 427.6 nmol/L (range, 0.1 to 1806 nmol/L). In the patient group including the reduced use of anticholinesterase after surgery the mean of level of AchR-Ab was 241.3 nmol/L while it was 10.8 nmol/L in the patient group including the non-reduced use of anticholinesterase (p = 0.082) after a mean follow-up period of 23 months postoperatively. The mean levels were 246.7 nmol/L and 8.5 nmol/L for the reduced and non-reduced use of corticosteroid patient groups, respectively (p = 0.001). In the 25 patients with fewer symptom after surgery the mean of the AchR-Ab level was 205.3 nmol/L while it was 18.3 nmol/L in the patients without any changes (p = 0.071). Conclusion: We concluded that the preoperative level of AchR-Ab was associated with postoperative dosage of anticholinesterase and corticosteroids and severity of symptoms postoperatively. We think that the levels of AchR-Ab titers can be a marker for the efficacy of thymic surgery.

The Effect of Preoperative AchR-Ab Level to the Prognosis in Operated Myasthenia Gravis Patients