Anti-acetylcholine receptor antibody titer with extended thymectomy in myasthenia gravis

Kagotani, K; Monden, Yasumasa; Nakahara, Kazunari; Fujii, Yoshitaka; Seike, Y; Kitamura, Soichiro; Masaoka, Akira; Kawashima, Yasunaru

doi:10.1016/s0022-5223(19)38654-4

Cited by 22 publications

(7 citation statements)

References 19 publications

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“…Kagotani highlighted the importance of Anti Ach R antibodies both as a prognostic factor and in determining the course of future therapy after thymectomy. 16 We did not find any significant difference in the complete remission rate based on the presence or absence of Anti Ach R antibodies. Fifteen out of 48 patients (31%) with positive antibodies achieved complete remission, compared to 16 out of 42 (38%) with negative antibodies.…”

Section: Discussionmentioning

confidence: 50%

“…While the role of surgery in generalized MG is widely accepted, this study has shown the Osserman classification not to be a significant predictor (Table 1). Furthermore, controversy remains concerning the role of thymectomy in pure ocular MG. 4,16 In this series, 7 patients with ocular MG were operated on. Two of these seven patients (28.5%) achieved complete remission and the other three improved (43%).…”

Section: Discussionmentioning

confidence: 99%

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Predictors of Outcome for Myasthenia Gravis after Thymectomy

El-Medany

Hajjar

Essa

et al. 2003

Asian Cardiovasc Thorac Ann

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The aim of this study was to assess the clinical outcome of patients with myasthenia gravis treated with maximal thymectomy and to identify prognostic variables that predict the outcome. Over 15 years, from 1986 to 2001, we collected data on 100 patients with myasthenia gravis who underwent maximal thymectomy and retrospectively reviewed their outcome. Women comprised 63% and the median age was 25 years (range, 4 to 61). The median duration of the disease was 26 months (range, 1 to 240). According to the Osserman classification, there were seven patients in class I, 31 in class II, 47 in class III, and 15 in class IV. In non thymomatous patients (93 patients), complete remission rate progressively increased from 37.4% to 58.2% and 75% at 3, 10 and 15 years of follow-up respectively. These findings suggest that the complete remission rate is prone to increase with time after maximal thymectomy. The total benefit rate achieved was estimated to be 86% while 14% did not improve at a mean follow-up period of 7.6 years (range, 8 to 180 months). Univariate analysis (p < 0.05) showed that age, thymic histology and ectopic thymic tissue are significant prognostic factors for outcome.

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Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Predictors of Outcome for Myasthenia Gravis after Thymectomy

El-Medany

Hajjar

Essa

et al. 2003

Asian Cardiovasc Thorac Ann

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“…The extended transsternal thymectomy 15,[22][23][24][25][26][27][28][29][30] is also known as aggressive transsternal thymectomy 31 or transsternal radical thymectomy. 32 The extent of these resections vary in the mediastinum and may or may not include all the mediastinal tissue removed by the "maximal" technique.…”

Section: Transsternal Thymectomiesmentioning

confidence: 99%

Thymectomy for NonthymomatousMyasthenia Gravis

Sonett

Jaretzki

2008

Annals of the New York Academy of Sciences

108

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There continues to be debate concerning which thymectomy technique is the procedure of choice in the treatment of nonthymomatous myasthenia gravis (MG). The debate persists primarily because of the lack of controlled prospective studies but also because of the varying presentations and clinical courses of MG patients. Analysis has been complicated by the absence, until very recently, of accepted objective definitions of severity of the illness and response to therapy as well as variable patient selection, timing of surgery, type of surgery, and methods of analysis of results. Without resolution of these issues by properly designed prospective studies, there can be no unequivocally valid comparison of the various thymectomy techniques. In this review, attempts have been made to clarify some of the controversial issues concerning the selection of a thymectomy technique in the treatment of nonthymomatous MG and to make limited recommendations based on the best available evidence.

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“…The good effect of both thymectomy and immunosuppressive drugs on clinical symptoms of M G has been well documented (12). A decrease in serum anti-AChR antibodies is often noted in anti-AChR antibody-positive patients after thymectomy (14,17,18) and/or during immunosuppressive medication (19)(20)(21). A good clinical response to the treatment is not, however, always associated with a decline in the titer of anti-AChR antibodies (22,23).…”

Section: Discussionmentioning

confidence: 99%

Effect of thymectomy and immunosuppressive therapy on anti-neuroblastoma antibody levels in patients with myasthenia gravis

Müller

Nykyri

Andersson

1991

Acta Neurologica Scandinavica

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Antibodies reacting with human neuroblastoma cells (NBL) are distinct from the "classical" anti-acetylcholine receptor (AChR) antibodies in myasthenia gravis (MG). The influence of therapeutic interventions on serum anti-NBL antibody levels was followed in 42 MG patients. Thymectomy alone was performed in 28 patients while immunosuppressive medication was given to 14 patients out of whom 10 also had a thymectomy. In most patients serum anti-NBL antibody titers declined after thymectomy and/or during immunosuppressive treatment, though individual variations in the antibody response could be observed. Sequential examinations of individual patients revealed an association between the clinical severity of MG and anti-NBL antibody levels. No correlation between the treatment-induced changes of anti-NBL and anti-acetylcholine receptor (AChR) antibody titers could be observed during the follow-up period in MG patients positive for both types of antibodies. These findings further emphasize the immunological complexity of MG. Anti-NBL antibodies represent a pathogenic marker of the disease and display a regulation different from that of the anti-AChR antibodies.

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Anti-acetylcholine receptor antibody titer with extended thymectomy in myasthenia gravis

Cited by 22 publications

References 19 publications

Predictors of Outcome for Myasthenia Gravis after Thymectomy

Predictors of Outcome for Myasthenia Gravis after Thymectomy

Thymectomy for NonthymomatousMyasthenia Gravis

Effect of thymectomy and immunosuppressive therapy on anti-neuroblastoma antibody levels in patients with myasthenia gravis

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