Abstract Details

Title Thymus and Myasthenia Gravis: Long-Term Follow-Up Screening of Thymectomized and Non-Thymectomized Patients

Topic Muscle Disease/Neuromuscular Junction

Presentation(s) P02 - (-)

Poster/Presentation
Number 189

Objective

Background BACKGROUND: Thymoma screening is recommended at the onset of myasthenia gravis (MG) or when patients with MG present with clinical deterioration or a progressive increase of anti-acetylcholine receptor antibody. However, it is unknown if it is necessary to repeat the screening of thymoma at fixed intervals, even in the absence of MG deterioration, when the initial screening is negative.

Design/Methods DESIGN/METHODS: We study MG patients with follow-up for more than five years, well-controlled disease, a first contrast-enhanced chest computerized tomography (CT) at the beginning of the disease and a second contrast-enhanced chest CT after five years. MG was considered well-controlled according to the Myasthenia Gravis Foundation of America (MGFA) classification and myasthenia gravis composite (MGC).

Results RESULTS: The sample consisted of 53 patients (44 female and 9 male), aged 17 to 72 years (median 41.8 years). The follow-up in our hospital varied between 75 and 472 months, with a mean time of 182.2±96.99 months. The MGFA classification and MGC score demonstrated that our patients' conditions were well controlled at the time the second chest CT was performed. The chest CT detected thymus abnormalities in 8 patients at the initial screening and no abnormalities in all patients at a second screening after 5 years. Twenty-one patients were thymectomized. The suspicion of thymoma based on the initial chest CT screening of 8 patients was confirmed by histopathological study in all cases.

Conclusions CONCLUSIONS: These findings indicate that routine screening for thymoma at fixed follow-up intervals is not needed for patients with well-controlled MG. The findings of this study support the classical opinion that screening for thymoma should be recommended only if there is clinical deterioration due to the disease.

Authors/Disclosures
Paulo J. Lorenzoni, MD (Neurology - Hospital De Clinicas - UFPR) PRESENTER	Dr. Lorenzoni has nothing to disclose.
	No disclosure on file
Claudia S. Kay, MD	Dr. Kay has nothing to disclose.
Rosana H. Scola, MD (Hospital De Clinicas, Departamento De Neurolog)	Dr. Scola has nothing to disclose.
Lineu C. Werneck, MD (Universidade Federal do Parana)	No disclosure on file
Silvia Messina (AOU Policlinico Vittorio Emanuele)	No disclosure on file

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