Online citations, reference lists, and bibliographies.
Please confirm you are human
(Sign Up for free to never see this)
← Back to Search

Thymectomy As Primary Therapy In Myasthenia Gravis

C. W. Olanow, A. Wechsler, M. Sirotkin-Roses, J. Stajich, A. Roses
Published 1987 · Medicine

Save to my Library
Download PDF
Analyze on Scholarcy
Share
In 1982 we presented the results of 47 consecutively presenting myasthenia gravis patients with generalized weakness who were treated by thymectomy according to a standardized protocol (FIG. 1 ).' Plasma exchange without immunosuppression was used to optimize medical status prior to surgery. Anticholinesterase agents were discontinued during plasma exchange in those patients who had received them prior to referral. Patients referred on corticosteroid medications were maintained on these drugs through surgery. Attempts were made to taper and discontinue them postoperatively. Efforts were made to avoid medication whenever possible. Drugs were introduced only when patients experienced deterioration in myasthenic status or had functionally disabling symptoms that persisted following thymectomy. When this population was analyzed after a mean follow-up of 25.5 months, 46 of 47 were improved, 83 percent were free of generalized weakness, and 61 percent were on no medication. Additionally, acetylcholine receptor antibody titers did not predict clinical response to thymectomy, nor did the acetylcholine receptor antibody titer correlate with the clinical status in individual patients. We concluded that (1) thymectomy is an effective therapy for most patients with myasthenia gravis; (2) routine administration of additional medication is not necessary in many patients, and ( 3 ) reduction in the acetylcholine receptor antibody titer is not essential for clinical benefit. These studies suggested the possibility that a "thymic factor" is critical to the development of clinical weakness in myasthenia gravis, and that, while the acetylcholine receptor antibody may play an important role in the pathogenesis of myasthenia gravis, it is the removal of a thymic factor that is responsible for clinical benefits following thymectomy. In the above study, patients were divided into two groups: those who received no previous treatment and those who had received medical therapy prior to referral. To better assess the natural history of thymectomy in the treatment of myasthenia gravis,
This paper references
There is no direct correlation between serum anti-acetylcholine receptor antibody levels and the clinical status
R.J.M. LANE (1981)
Myasthenia gravis . Part 11
J. E. CAMPA (1978)
Regulation of the immune response - inducer and suppressor T lymphocytes subsets in human beings
C. W. OLANOW (1981)
Thymosin a 1 in myasthenia gravis
C. W. OLANOW (1983)
10.1056/NEJM198008143030704
Current concepts in immunology: Regulation of the immune response--inducer and suppressor T-lymphocyte subsets in human beings.
E. Reinherz (1980)
Treatment of myasthenia gravis in the elderly
M. C. DALAKAS (1980)
10.1212/WNL.27.12.1103
A treatment carol
M. Mcquillen (1977)
10.1016/S0003-4975(10)65278-2
Surgical management of myasthenia gravis.
W. Wolfe (1972)
10.1016/0002-9343(75)90125-4
Studies in myasthenia gravis: early thymectomy. Electrophysiologic and pathologic correlations.
G. Genkins (1975)
10.1056/NEJM198005083021921
Thymosin alpha 1 in myasthenia gravis.
M. Dalakas (1980)
A treatment carol: thymectomy
P M. (1977)
Study of anticholinesterase therapy effects on neuro-muscular transmission and on motor end-plate fine structure
A G Engel (1973)
A prospective study of thymectomy and the acetylcholine receptor antibodies in human myasthenia gravis
C. W. OLANOW (1982)
10.1111/j.1749-6632.1971.tb30761.x
THE ROLE OF THYMECTOMY IN THE TREATMENT OF MYASTHENIA GRAVIS
V. Perlo (1971)
Studies in myasthenia gravis . Review of 20 year experience in over 1200 patients
A. SIMPSON (1971)
Study of anticholinesterase therapy
T. SANTA (1973)
10.1016/0002-9610(74)90094-4
Effect of thymectomy in patients with myasthenia gravis. A sixteen year experience.
D. Mulder (1974)
10.1056/NEJM197801262980404
Myasthenia gravis (second of two parts).
Drachman Db (1978)
High - dose daily prednisone in the treatment of myasthenia gravis
P. C. Dau (1979)
10.1016/S0022-5223(19)37714-1
Thymectomy for myasthenia gravis in the young adult. Long-term results.
R. Clark (1980)
A treatment carol : thymectomy revisited
C. W. OLANOW (1986)
10.1016/0306-9877(81)90051-7
The pathogenesis of myasthenia gravis--a hypothesis.
C. Olanow (1981)
10.1097/00000658-198208000-00001
A Prospective Study of Thymectomy and Serum Acetylcholine Receptor Antibodies in Myasthenia Gravis
C. W. Olanow (1982)
10.1212/WNL.23.12.1273
Study of long‐term anticholinesterase therapy
A. Engel (1973)
Thymectomy for myasthenia gravis in the young adult
B. EMERYK (1980)
Neostigmineinduced alterations at the mammalian neuromuscular junction
C S Hudson (1978)
10.1212/WNL.26.8.729
Long‐term administration of corticosteroids in myasthenia gravis
J. Mann (1976)
Effect of thymectomy on peripheral lymphocyte subsets in myasthenia gravis: selective effect on T-cells in patients with thymic atrophy.
B. Haynes (1983)
10.1212/WNL.31.2.220
No direct correlation between serum antiacetylcholine receptor antibody levels and clinical state of individual patients with myasthenia gravis
A. Roses (1981)
There is no direct correlation between serum anti - acetylcholine receptor antibody levels and the clinical status of individual patients with myasthenia gravis
M. W. MCADAMS (1981)
10.1016/S0140-6736(75)92203-5
Myasthenia Gravis
D. Elmqvist (1966)
10.1093/BRAIN/81.1.112
An evaluation of thymectomy in myasthenia gravis.
J. Simpson (1958)
10.1097/00000658-197610000-00008
The Value of Thymectomy in Myasthenia Gravis: A Computer‐Assisted Matched Study
J. Buckingham (1976)



This paper is referenced by
10.1007/0-387-24534-0_12
Intrathymic expression of neuromuscular acetylcholine receptors and the immunpathogenesis of myasthenia gravis.
A. Levinson (2003)
10.1016/S0300-2896(15)30318-5
Tratamiento de la miastenia grave mediante timectomía videotoracoscópica. Técnica y resultados iniciales
J. Loscertales (1999)
10.1016/S0960-8966(00)00173-5
Therapeutic options in ocular myasthenia gravis
A. Evoli (2001)
10.1212/WNL.48.Suppl_5.52S
Thymectomy for myasthenia gravis
A. Jaretzki (1997)
10.1016/0953-4431(96)00149-X
Ocular myasthenia gravis secondary to thymoma
Robert C. Capone (1996)
10.1111/J.1749-6632.1993.TB22945.X
How Reliable Are Imaging Procedures in Detecting Residual Thymus after Previous Thymectomy?
P. Kornfeld (1993)
Miastenia Gravis: revisión para el anestesiólogo
JoséVicente Aragón (1997)
10.1055/s-2008-1062260
Autoimmune disorders of neuromuscular transmission.
Branavan Mahadeva (2008)
10.1007/s001040050582
Thymektomie bei Myasthenia gravis – eine Standortanalyse
W. Schulze (1998)
10.1016/S0091-6749(99)70431-8
Long-term immunologic effects of thymectomy in patients with myasthenia gravis.
R. Gerli (1999)
10.1212/WNL.41.6.923
Repeat thymectomy in chronic refractory myasthenia gravis
R. Miller (1991)
10.1007/s001010100166
Anästhesie bei Patienten mit Myasthenia gravis
M. Blobner (2001)
10.1136/jnnp.54.5.406
Actuarial analysis of the occurrence of remissions following thymectomy for myasthenia gravis in 400 patients.
L. Durelli (1991)
10.1007/BF00210924
Video-assisted thoracoscopic management of anterior mediastinal masses
A. Yim (2004)
10.1016/B978-0-443-06861-4.50144-1
THORACOSCOPIC THYMECTOMY FOR MYASTHENIA GRAVIS
C. Ng (2008)
10.1016/j.jns.2012.12.025
Modeling the intrathymic pathogenesis of myasthenia gravis
A. Levinson (2013)
Myasthenia gravis in the North of Portugal: epidemiological, clinical and serological study and immunopathology of the thymus
Maria Ernestina Santos (2018)
10.1590/S0004-282X1990000100009
Miastenia grave avaliação crítica dos tratamentos
J. L. Assis (1990)
10.1080/00325481.1993.11945736
Myasthenia gravis.
M. Juhn (1993)
10.1016/0022-510X(91)90137-V
Analysis of prognostic factors in thymectomized patients with myasthenia gravis: Correlation between thymic lymphoid cell subsets and postoperative clinical course
N. Fujii (1991)
10.1097/00000658-199910000-00011
Results of transcervical thymectomy for myasthenia gravis in 100 consecutive patients.
R. Calhoun (1999)
Thymic hyperplasia in a patient with Graves' disease.
L. Hsu (2001)
10.1046/j.1445-2197.2002.02294.x
Paradigm shift in surgical approaches to thymectomy
A. Yim (2002)
10.1111/J.1748-5827.1992.TB01028.X
Canine myasthenia gravis
A. L. Hopkins (1992)
10.1067/MSY.2001.116674
Long-term evaluation of extended thymectomy with anterior mediastinal dissection for myasthenia gravis.
L. E. Stern (2001)
10.1111/j.1749-6632.1998.tb11020.x
Treatment Algorithm for Autoimmune Myasthenia Gravis in Childhood
P. I. Andrews (1998)
10.1378/CHEST.108.5.1440
[Video assisted thoracoscopic thymectomy for myasthenia gravis].
P. Yim (1996)
10.1136/ADC.64.8.1191
Treatment for refractory myasthenia gravis.
T. Sakano (1989)
10.1212/WNL.40.5.786
The relationship of age to outcome in myasthenia gravis
D. Donaldson (1990)
10.1089/10926410152403039
Thoracoscopic Thymectomy for Myasthenia Gravis in Children
K. A. Kogut (2001)
10.1016/S1010-7940(99)00052-4
Thymectomy for myasthenia gravis: a 27-year experience.
F. Venuta (1999)
10.1016/0090-1229(89)90083-4
Experience with intravenous immunoglobulin in myasthenia gravis.
E. Arsura (1989)
See more
Semantic Scholar Logo Some data provided by SemanticScholar