Premium
Eight‐year follow‐up of patients with myasthenia gravis after thymectomy
Author(s) -
Yu S.,
Li F.,
Chen B.,
Lin J.,
Yang M.,
Fu X.,
Li J.,
Bu B.
Publication year - 2015
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12289
Subject(s) - thymectomy , myasthenia gravis , thymoma , medicine , ocular myasthenia , perioperative , surgery , concomitant , pediatrics
Purpose To depict the long‐term outcome of patients with myasthenia gravis after thymectomy in combination with immunotherapy, and the factors that may potentially affect the outcome. Methods The 306 patients with myasthenia gravis who underwent extended thymectomy from J anuary 1984 to D ecember 2011 at T ongji H ospital were retrospectively evaluated. Results The patients consisted of 174 cases with thymoma and 132 cases without thymoma. Pharmaceutical treatment was tailored for each case during follow‐up. Nine patients with thymomatous myasthenia gravis died during the perioperative period, and 297 patients were followed for 8.6 years. By their latest visits, 241 patients (81.1%) gained satisfactory efficacy, 24 cases died (8.1%), and 32 cases (10.8%) remained unchanged or deteriorated. Favorable factors for satisfactory efficacy included the presence of ocular myasthenia gravis before operation, no presence of thymoma, and lack of concomitant diseases. It is interesting to mention that, patients with non‐thymomatous myasthenia gravis obtained significantly higher rates of complete stable remission and clinical remission than the patients with thymomatous myasthenia gravis. Conclusions Extended thymectomy combined with immunotherapy is a preferred treatment with a satisfactory long‐term remission rate. Patients with non‐thymomatous myasthenia gravis have a much more promising prognosis than the patients with thymomatous myasthenia gravis. However, appropriate caution must be taken to discontinue pharmaceutical therapy as relapse remains a major concern after a patient who has already undergone thymectomy becomes symptom‐free.