[pubmed] Thymoma pathology and Myasthenia Gravis outcomes

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Muscle Nerve. 2021 Mar 6. doi: 10.1002/mus.27220. Online ahead of print.

ABSTRACT

INTRODUCTION: There is limited evidence regarding the impact of World Health Organisation (WHO) subtype of thymoma on post-thymectomy outcome of thymoma-associated myasthenia gravis (TAMG). The objective was to determine if the pathological subtypes of thymoma were associated with post-thymectomy outcomes of myasthenia gravis (MG), in patients with TAMG.

METHODS: We performed a retrospective study of consecutive patients with TAMG who attended the neuromuscular clinic between January 2018 and December 2019 with a minimum follow-up of 1 year after thymectomy. Outcome measures were MG impairment index (MGII), single-simple question (SSQ), Myasthenia Gravis Foundation of America post-intervention status (MGFA PIS) and non-responder MG status at last assessment.

RESULTS: 95 patients were included; mean age at onset was 48.1 ± 12.1 years; 54(56.8%) were females. Thirteen patients developed MG post-thymectomy. The most common thymoma was WHO type B2 in 39(41.1%) Most patients (40, 42.1%) had Masaoka stage II thymoma. There was no association of thymoma subtypes or Masaoka stage of disease with age, gender, MG phenotype, serology, post-thymectomy onset, interval from onset to thymectomy, MGII, SSQ, MGFA PIS or non-responder status. Associations were found between positive serology and lower MGII (11.1 ± 14.2 vs 23 ± 12.9, p = 0.050), thymic follicular hyperplasia (TFH) and higher SSQ (89.3 ± 11.7 vs 80.1 ± 20.2, p-0.043), and lack of recurrence and higher SSQ (84.1 ± 18 vs 72.5 ± 20, p = 0.037).

DISCUSSION: The WHO pathological subtype of thymoma did not correlate with MG outcomes. However, positive acetylcholine antibody serology, presence of TFH and non-recurrence of thymoma, predict a favourable outcome. This article is protected by copyright. All rights reserved.

PMID:33675078 | DOI:10.1002/mus.27220


Source: https://pubmed.ncbi.nlm.nih.gov/3367507 ... 0&v=2.14.2