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Abstract Details

Bronchiectasis in Myasthenia Gravis: A Clinically Relevant Comorbidity Defining a High-risk Triad With Thymoma
Neuromuscular and Clinical Neurophysiology (EMG)
P4 - Poster Session 4 (8:00 AM-9:00 AM)
9-014

To determine the prevalence, clinical relevance, and risk factors for bronchiectasis in myasthenia gravis (MG).

MG can cause respiratory muscle weakness and lead to respiratory failure. Comorbid respiratory disease, as bronchiectasis (234/100,000 in Israel), may increase this risk, but its prevalence and relevance in MG remain unclear.

We retrospectively analyzed 238 MG patients at Tel Aviv Sourasky Medical Center. BE was confirmed by high-resolution chest CT, and data on demographics, clinical features, and immunology were collected. BE prevalence was also assessed in 111 thymoma patients without MG. Group comparisons used Fisher’s exact test, and logistic regression evaluated the independent and combined effects of MG and thymoma, including interaction terms. ORs with 95% CIs were calculated.
BE was more frequent in patients with both MG and thymoma (19.6%) compared to MG without thymoma (5.9%, OR 3.9, 95% CI 1.6-9.8, p = 0.0047), thymoma without MG (3.6%, OR 6.5, 95% CI 1.9-22, p = 0.0016), and the general population (0.23%). ORs for BE were significantly elevated in all subgroups compared to the general population: 104.0 (95% CI 51.5-210.0, p = 7.2 × 10?¹7), 26.6 (95% CI 14.3-49.7, p = 1.9 × 10?¹²), and 15.9 (95% CI 5.8-43.6, p = 1.5 × 10?4), respectively. Bulbar symptoms were not associated with BE (p=0.500). MG and thymoma were independently associated with BE, but a negative interaction term (β = -1.41, p = 0.043) suggested overlapping mechanisms. BE was associated with increased risk of myasthenic crisis (30.4% vs. 6.7%, OR = 6.1, p = 0.002), especially in the presence of thymoma (60% vs. 8.3%, OR = 16.5, p = 0.020).

Bronchiectasis is an underrecognized but clinically relevant comorbidity in MG, particularly with thymoma, forming a triad associated with a high-risk disease phenotype. Its presence may reflect an autoimmune-mediated form of BE linked to the MG-thymoma spectrum.
Authors/Disclosures
Arnon Karni, MD, PhD (Tel Aviv Sourasky medical center)
PRESENTER 		Prof. Karni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neopharm. Prof. Karni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BMS. Prof. Karni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Prof. Karni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. The institution of Prof. Karni has received research support from Medison. The institution of Prof. Karni has received research support from BMS. The institution of Prof. Karni has received research support from Novartis.
Ifat Vigiser (Tel Aviv Medical Center) Ifat Vigiser has nothing to disclose.
Alon Doron, MD Dr. Doron has nothing to disclose.
Keren Regev, MD Dr. Regev has nothing to disclose.
Hadar Kolb Hadar Kolb has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Hadar Kolb has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Hadar Kolb has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for MAPI pharma. Hadar Kolb has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neopharm Scientific. Hadar Kolb has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Marck. The institution of Hadar Kolb has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MAPI pharma. Hadar Kolb has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medison pharma. Hadar Kolb has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Marck.
Inbal Friedman Regev, MD Dr. Friedman regev has nothing to disclose.
Amir Bar Shai, MD Dr. Bar Shai has nothing to disclose.