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Subclinical myasthenia gravis in thymomas

Florit D. Marcuse, Monique Hochstenbag, Janneke G.J. Hoeijmakers, Myrurgia Abdul Hamid, Jan Damoiseaux, Jos Maessen, Marc De Baets
European Respiratory Journal 2021 58: PA3097; DOI: 10.1183/13993003.congress-2021.PA3097
Florit D. Marcuse
1MUMC, Maastricht, Netherlands
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  • For correspondence: florit.marcuse@mumc.nl
Monique Hochstenbag
1MUMC, Maastricht, Netherlands
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Janneke G.J. Hoeijmakers
1MUMC, Maastricht, Netherlands
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Myrurgia Abdul Hamid
1MUMC, Maastricht, Netherlands
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Jan Damoiseaux
1MUMC, Maastricht, Netherlands
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Jos Maessen
1MUMC, Maastricht, Netherlands
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Marc De Baets
1MUMC, Maastricht, Netherlands
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Abstract

A proportion of thymoma-patients without a history of myasthenia gravis (MG) before thymectomy, appears to have positive anti-AChR-antibodies in the serum. We retrospectively analyzed 398 consecutive patients who underwent a robotic-assisted thoracoscopic surgery at the Maastricht University Medical Center+ (MUMC+) between April 2004 and December 2018. In the MUMC+, a robotic approach is the standard surgical approach in patients with thymic diseases. Of the 102 included thymoma-patients, 87 patients (85%) were tested for anti-AChR-antibodies before thymectomy, of which 57 patients were diagnosed with clinical MG and seven subclinical MG-patients were found. Of the 15 patients who were not tested for anti-AChR-antibodies, four more subclinical MG-patients were discovered in the years after thymectomy. The median follow-up time was 62 months. In total, 11 subclinical MG-patients were found, with a mean age of 54 years and predominantly females (64%). Ten subclinical MG-patients (91%) developed clinical-MG, within six years after thymectomy. Immunosuppressive drugs were prescribed in five patients. Four patients were diagnosed with a recurrence of the thymoma. No surgical mortality was reported. Two patients died due to a myasthenic crisis. The prevalence of subclinical MG in thymomas was found to be 10.8%. One in four patients who experienced no neurological symptoms before thymectomy, appeared to have anti-AChR-antibodies and 91% of these patients developed clinical MG within six years after the thymectomy. Analyzing anti-AChR-antibodies in the serum is recommended in all suspected thymomas before a thymectomy is performed.

  • Immunology
  • Diagnosis
  • Mediastinal tumour

Footnotes

Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3097.

This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2021
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Subclinical myasthenia gravis in thymomas
Florit D. Marcuse, Monique Hochstenbag, Janneke G.J. Hoeijmakers, Myrurgia Abdul Hamid, Jan Damoiseaux, Jos Maessen, Marc De Baets
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3097; DOI: 10.1183/13993003.congress-2021.PA3097

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Subclinical myasthenia gravis in thymomas
Florit D. Marcuse, Monique Hochstenbag, Janneke G.J. Hoeijmakers, Myrurgia Abdul Hamid, Jan Damoiseaux, Jos Maessen, Marc De Baets
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3097; DOI: 10.1183/13993003.congress-2021.PA3097
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