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. 1976 Oct;184(4):453–458. doi: 10.1097/00000658-197610000-00008

The value of thymectomy in myasthenia gravis: a computer-assisted matched study.

J M Buckingham, F M Howard Jr, P E Bernatz, W S Payne, E G Harrison Jr, P C O'Brien, L H Weiland
PMCID: PMC1345441  PMID: 1015890

Abstract

In the absence of a prospective randomized study of patients treated conservatively or with thymectomy, a computer-assisted retrospective matches study was devised. Of 563 patients treated for myasthenia gravis without thymoma up to 1965, 104 had thymectomy. With computer assistance, each surgical patient was matched with a medical patient on the basis of age, sex, and severity and duration of disease. On this basis 80 of the 104 surgical patients could be matched satisfactorily. There were 16 males and 64 females in each of the matched surgically treated and medical control groups. A complete remission was experienced by 27 of the 78 patients in the surgical group as compared to 6 of the medical group. Improvement was noted by 26 of 78 surgically treated patients and 13 of 78 receiving medical treatment. Survival for patients having thymectomy. Thirty-four patients in the medical group had died as compared to 11 in the surgical group. Comparison of survival in relation to sex, duration of symptoms, or age (less than 30 or less than 30 years) did not show a significant difference. Until more effective treatment is available for myasthenia gravis, thymectomy deserves consideration for both sexes, and with increased age or long duration of symptoms.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alpert L. I., Papatestas A., Kark A., Osserman R. S., Osserman K. A histologic reappraisal of the thymus in myasthenia gravis. A correlative study of thymic pathology and response to thymectomy. Arch Pathol. 1971 Jan;91(1):55–61. [PubMed] [Google Scholar]
  2. Blalock A., Mason M. F., Morgan H. J., Riven S. S. MYASTHENIA GRAVIS AND TUMORS OF THE THYMIC REGION: REPORT OF A CASE IN WHICH THE TUMOR WAS REMOVED. Ann Surg. 1939 Oct;110(4):544–561. doi: 10.1097/00000658-193910000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. EATON L. M., CLAGETT O. T. Present status of thymectomy in treatment of myasthenia gravis. Am J Med. 1955 Nov;19(5):703–717. doi: 10.1016/s0002-9343(55)80012-5. [DOI] [PubMed] [Google Scholar]
  4. Edwards F. R., Wilson A. Thymectomy for myasthenia gravis. Thorax. 1972 Sep;27(5):513–516. doi: 10.1136/thx.27.5.513. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Genkins G., Papatestas A. E., Horowitz S. H., Kornfield P. Studies in myasthenia gravis: early thymectomy. Electrophysiologic and pathologic correlations. Am J Med. 1975 Apr;58(4):517–524. doi: 10.1016/0002-9343(75)90125-4. [DOI] [PubMed] [Google Scholar]
  6. KEYNES G. The results of thymectomy in myasthenia gravis. Br Med J. 1949 Sep 17;2(4628):611–616. doi: 10.1136/bmj.2.4628.611. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Lennon V. A., Lindstrom J. M., Seybold M. E. Experimental autoimmune myasthenia: A model of myasthenia gravis in rats and guinea pigs. J Exp Med. 1975 Jun 1;141(6):1365–1375. doi: 10.1084/jem.141.6.1365. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Mackay I. R., Whittingham S., Goldstein G., Currie T. T., Hare W. S. Myasthenia gravis: clinical, serological and histological studies in relation to thymectomy. Australas Ann Med. 1968 Feb;17(1):1–11. doi: 10.1111/imj.1968.17.1.1. [DOI] [PubMed] [Google Scholar]
  9. Mittag T., Kornfeld P., Tormay A., Woo C. Detection of anti-acetylcholine receptor factors in serum and thymus from patients with myasthenia gravis. N Engl J Med. 1976 Mar 25;294(13):691–694. doi: 10.1056/NEJM197603252941303. [DOI] [PubMed] [Google Scholar]
  10. Perlo V. P., Poskanzer D. C., Schwab R. S., Viets H. R., Osserman K. E., Genkins G. Myasthenia gravis: evaluation of treatment in 1,355 patients. Neurology. 1966 May;16(5):431–439. doi: 10.1212/wnl.16.5.431. [DOI] [PubMed] [Google Scholar]
  11. SIMPSON J. A. An evaluation of thymectomy in myasthenia gravis. Brain. 1958 Mar;81(1):112–144. doi: 10.1093/brain/81.1.112. [DOI] [PubMed] [Google Scholar]
  12. Seybold M. E., Howard F. M., Jr, Duane D. D., Payne W. S., Harrison E. G., Jr Thymectomy in juvenile myasthenia gravis. Arch Neurol. 1971 Nov;25(5):385–392. doi: 10.1001/archneur.1971.00490050019001. [DOI] [PubMed] [Google Scholar]

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