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CC BY-NC-ND 4.0 · Eur J Pediatr Surg 2022; 32(06): 543-549
DOI: 10.1055/s-0042-1744150
Original Article

Childhood-Onset Myasthenia Gravis Patients Benefited from Thymectomy in a Long-Term Follow-up Observation

Qing Zhang 
1   Department of Neurology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
,
Yayun Cao
2   Department of Radiology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei Province, China
,
Zhuajin Bi
1   Department of Neurology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
,
Xue Ma
1   Department of Neurology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
,
Mengge Yang
1   Department of Neurology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
,
Huajie Gao
1   Department of Neurology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
,
Mengcui Gui
1   Department of Neurology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
,
Bitao Bu
1   Department of Neurology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
› Author Affiliations Funding This work was supported by a grant from the National Natural Science Foundation of China (No. 81873758).
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Abstract

Introduction The effect of thymectomy on the treatment of childhood-onset myasthenia gravis (CMG) remains debatable. The objective of this study was to evaluate the clinical outcome and relevant prognostic factors of thymectomy for CMG patients.

Materials and Methods A total of 32 CMG patients who underwent thymectomy before 18 years of age were included in this retrospective study. Clinical state following thymectomy was assessed by quantified myasthenia gravis (QMG) scores, myasthenia gravis–related activities of daily living (MG-ADL) scores, and Myasthenia Gravis Foundation of America postintervention status. Repeated-measures analysis of variance (ANOVA) examined the changes in postoperative scores during the 5-year follow-up. Univariate logistic regression was applied to identify factors associated with short-term (1-year postoperation) and long-term (5-year postoperation) clinical outcomes.

Results Repeated-measures ANOVA showed that QMG scores (F = 6.737, p < 0.001) and MG-ADL scores (F = 7.923, p < 0.001) decreased gradually with time. Preoperative duration (odds ratio [OR] = 0.85, 95% confidence interval [CI]: 0.73–1.00, p = 0.043), gender (OR = 0.19, 95% CI: 0.04–0.94, p = 0.041), and MG subgroup (OR = 13.33, 95% CI: 1.43–123.99, p = 0.023) were predictors for 1-year postoperative prognosis. Shorter disease duration (OR = 0.82, 95% CI: 0.70–0.97, p = 0.018) and generalized CMG (OR = 6.11, 95% CI: 1.06–35.35, p = 0.043) were found to have more favorable long-term results.

Conclusion Our results suggest that thymectomy is effective in treating CMG. Thymectomy could be recommended for CMG patients, especially for patients in the early course of GMG.

Keywords

childhood-onset myasthenia gravis - thymectomy - prognosis


Publication History

Received: 27 November 2021

Accepted: 17 January 2022

Article published online:
09 March 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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