1.Correlation between the atypical presentation of myasthenia gravis and radio-pathological classification of the thymus – A retrospective cohort study
Kang-Po Lee ; Chou-Ching K. Lin ; Pei-Fang Su ; Yu-Lin Mau ; Fei-Ci Sie ; Han-Wei Huang
Neurology Asia 2020;25(3):293-298
Myasthenia gravis (MG) is a disease of neuromuscular junction and mainly autoimmune in aetiology.
The state of thymus is a critical determinant for the prognosis. In this retrospective review study, we
aimed at clarifying the relationship between the mode of clinical presentation of MG and the radiopathological classification of the thymus. We identified patients with MG from the database of our
medical center from 1988 – 2017. The patients were classified into two groups according to their
clinical presentation: those with a typical presentation with diurnal variation, and those with an atypical
presentation of persistent weakness or respiratory failure from the beginning. The underlying thymic
state was categorized into six groups: normal, abnormal by imaging (if no operation was performed),
hyperplasia, benign thymoma, cortical type thymoma, and malignant thymoma. In total, 227 patients
(133 females and 94 males) were included in the analysis, of whom 68% were classified into the
typical presentation group. The atypical presentation correlated significantly with thymic categories
(p = 0.014) and sex (p = 0.026) but not age at onset (p = 0.232). The atypical presentation was more
common in the male patients and in those with thymic carcinoma.