Retrospective Analyses of Clinical Features and Therapeutic Outcomes in Thymectomized Patients with Myasthenia Gravis at Shinshu University

Abstract

Objectives Thymectomy has become recognized as an integral element in the treatment of patients with myasthenia gravis (MG). Although the incidence of elderlyonset MG has recently been increasing, there is little data demonstrating the efficacy and complications of thymectomy in this population. To clarify this point, we divided the thymectomized patients with MG into young and elderly groups, and retrospectively examined their clinical features and therapeutic outcomes.Patients and Methods We reviewed 57 MG patients who had been admitted to our hospital between 1988 and 2002. The patients were classified into young (younger than 60) and elderly (60 or older) groups according to the age of onset, and the therapeutic outcomes of thymectomy were evaluated using myasthenic severity scales and the duration from operation to discharge.Results Myasthenic severity scales significantly improved after thymectomy in the elderly group both with (p<0.005) and without thymoma (p<0.05) compared with before. With regard to the duration from thymectomy to discharge, no significant difference could be found between the young and elderly groups, irrespective of associated thymoma. There were no serious complications during and after thymectomy in either the young or the elderly group.Conclusions Despite various possible complications due to aging, thymectomy should be actively considered also in the treatment of elderly MG patients because it can reliably and safely improve myasthenic symptoms in combination with immunosuppressive agents, including corticosteroid. (Internal Medicine 43: [189][190][191][192][193] 2004)

Treatment of Myasthenia Gravis in Patients with Elderly Onset at Advanced Age

“…An increase in the incidence of elderly-onset MG has been reported in publications over recent years, [1][2][3][4] although development of the disease in patients 80 years of age represents a particularly advanced age of onset. The prevalence of MG in patients 80 years is unclear but the number of patients being diagnosed suggests an increase in incidence or an improvement in physicians' diagnostic skills or both.…”

“…However, elderly-onset MG has been also reported among patients 65 years of age. [1][2][3][4] Thymus abnormalities are usually rare among patients with late-onset MG, aged 50 and above, and clinical presentation is also different from those with early-onset disease, aged less than 50 years old. 5 Differential diagnosis in elderly patients must consider cerebral stroke, motor neuron disease, and Parkinson's disease as the majority present with bulbar symptoms.…”