Thymectomy

Minimal manifestation status and prednisone withdrawal in the MGTX trial

OBJECTIVE: To examine whether sustained minimal manifestation status (MMS) with complete withdrawal of prednisone is better achieved in thymectomized patients with myasthenia gravis (MG). METHODS: This study is a post hoc analysis of data from a randomized trial of thymectomy in MG (Thymectomy Trial in Non-Thymomatous Myasthenia Gravis Patients Receiving Prednisone Therapy [MGTX]). MGTX was a multicenter, randomized, rater-blinded 3-year trial that was followed by a voluntary 2-year extension for patients with acetylcholine receptor (AChR) antibody-positive MG without thymoma.

Italian recommendations for the diagnosis and treatment of myasthenia gravis

Myasthenia gravis is a well-treatable disease, in which a prompt diagnosis and an adequate management can achieve satisfactory control of symptoms in the great majority of patients. Improved knowledge of the disease pathogenesis has led to recognition of patient subgroups, according to associated antibodies, age at onset and thymus pathology, and to a more personalized treatment. When myasthenia gravis is suspected on clinical grounds, diagnostic confirmation relies mainly on the detection of specific antibodies.

Long-term effect of thymectomy plus prednisone versus prednisone alone in patients with non-thymomatous myasthenia gravis. 2-year extension of the MGTX randomised trial

Background: The Thymectomy Trial in Non-Thymomatous Myasthenia Gravis Patients Receiving Prednisone (MGTX) showed that thymectomy combined with prednisone was superior to prednisone alone in improving clinical status as measured by the Quantitative Myasthenia Gravis (QMG) score in patients with generalised non-thymomatous myasthenia gravis at 3 years. We investigated the long-term effects of thymectomy up to 5 years on clinical status, medication requirements, and adverse events.

Simultaneous MALT lymphoma of the thymus and parotid gland. Independent lymphomas or metastatic spread?

Background: Mucosa associated lymphoid tissue (MALT) lymphoma of the thymus is rare and generally associated with autoimmune disorders. It is generally suspected in middle-aged asian women with Sjogren’s syndrome or other autoimmune diseases presenting a multicystic mediastinal mass. Contrary to other MALT lymphomas, the etiology of these tumors is still uncertain especially those affecting patients with no autoimmune diseases. Thymic MALT lymphoma with simultaneous salivary gland involvement is extremely rare, with only few cases described in literature.

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