Open AccessDisappearance of Anti-Thyroid Autoantibodies following Thymectomy in Patients with Myasthenia Gravis
Author(s) -
Giovanna Rotondo Dottore,
Marenza Leo,
Rocco Ricciardi,
Michelangelo Maestri,
Ilaria Bucci,
Marco Lucchi,
Franca Melfi,
Melania Guida,
Anna De Rosa,
Loredana Petrucci,
Ilaria Ionni,
Giulia Lanzolla,
Francesca Nicolì,
Michele Mantuano,
Debora Ricci,
Francesco Latrofa,
Stefano Mariotti,
Claudio Marcocci,
Michele Marinò
Publication year - 2020
Publication title -
european thyroid journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.23
H-Index - 10
eISSN - 2235-0802
pISSN - 2235-0640
DOI - 10.1159/000510701
Subject(s) - thymectomy , medicine , autoantibody , myasthenia gravis , thyroglobulin , autoimmunity , thymoma , thyroid , anti thyroid autoantibodies , thyroid peroxidase , thyroidectomy , immunology , endocrinology , immune system , antibody
Objectives: The thymus plays a central role in immune tolerance, which prevents autoimmunity. Myasthenia gravis (MG) is commonly associated with thymoma or thymus hyperplasia, and it can coexist with autoimmune thyroid diseases. However, the role of the thymus in thyroid autoimmunity remains to be clarified, which we investigated here. Study Design: The study design entailed the inclusion of consecutive MG patients and the measurement of anti-thyroid autoantibodies at baseline and, limited to autoantibody-positive patients, also at 24 and 48 weeks. One hundred and seven MG patients were studied. The main outcome measure was the behaviour of anti-thyroglobulin autoantibodies (TgAbs) and anti-thyroperoxidase autoantibodies (TPOAbs) over time in relation to thymectomy. Results: Serum TgAbs and/or TPOAbs were detected in ∼20% of patients in the absence of thyroid dysfunction. The prevalence of positive serum TgAbs and/or TPOAbs decreased significantly ( p = 0.002) over the follow-up period in patients who underwent thymectomy, but not in patients who were not thymectomized. When the analysis was restricted to TgAbs or TPOAbs, findings were similar. On the same line, there was a general trend towards a reduction in the serum concentrations of anti-thyroid autoantibodies in patients who underwent thymectomy, which was significant for TPOAbs ( p = 0.009). Conclusions: Our findings suggest a role of the thymus in the maintenance of humoral thyroid autoimmunity.