Long-Term Prognosis of Patients with Thymoma-Associated Myasthenia Gravis
Pathogenesis of myasthenia gravis (MG) is heterogeneous, however it is not possible to distinguish between myasthenia gravis associated with lymphofollicular hyperplasia (LFH) in the thymus or thymoma only by clinical signs and symptoms. In paraneoplastic MG pathogenesis can be clearly distinguished from MG associated with LFH. Not only the morphological finding in the thymus and thymoma is different, but there also seems to be no genetic predisposition and no significant therapeutic effect of thymomectomy on the clinical course of MG in the thymoma patients, whereas an association with the HLA typ A1/B8/DR3 and a therapeutic effect of thymectomy is shown in MG patients with LFH (7). Long term prognosis of patients with thymoma associated MG could be influenced by several factors e.g. thymoma morphology, thymic remnant, tumor size and infiltration or invasion into adjacent organs, operation technique, post- or preoperative radiation, chemotherapy, and recurrence of tumor. 30 years ago long term prognosis was mainly limited by the poor outcome of thymoma associated myasthenia gravis, because many of these patients suffered or even died from myasthenic crisis, today this should no longer be the case because of the better immunosuppressive and supportive therapies.
KeywordsAlopecia Areata Thymic Carcinoma Postoperative Adjuvant Therapy Term Prognosis Myasthenic Crisis
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