Effect of thymectomy on prognosis in non-thymomatous myasthenia gravis patients with acetylcholine receptor antibody positivity

Purpose: This study aims to evaluate the one-year clinical follow-up outcomes of Myasthenia Gravis patients who are acetylcholine receptor antibody positive and have undergone thymectomy, and to investigate the effect of thymectomy on prognosis. Materials and Methods: A total of 94 patients meeting the defined protocol were included in the study. Evaluation continued with 49 patients diagnosed with non-thymomatous myasthenia gravis. Demographic data, medications and dosages used in the pre- and postoperative periods, the need for apheresis and intravenous immunoglobulin before surgery, presence and number of myasthenic crises, postoperative hospital stay, complications (if any), post-discharge treatment plan, current pharmacotherapy and dosages, thymus pathology results, and MGFA (Myasthenia Gravis Foundation of America) stages at preoperative and postoperative 12th month were evaluated comparatively. Results: The mean age of the included non-thymomatous patients was 42.52 ± 14.89 years. The average postoperative hospital stay was 6.24 ± 2.70 days. It was determined that the dosages of pyridostigmine, steroid and immunosuppressive drugs (azothioprine), decreased in the postoperative period compared to the preoperative period. Positive clinical outcomes (MGFA stage 1 and 2) were observed in 63.3% of the patients and complete clinical remission was achieved in 6.1%. Conclusion: This study supports the benefit of thymectomy in patients with acetylcholine receptor antibody positive non-thymomatous myasthenia gravis, showing that both severe and mild myastenia gravis patients benefit from thymectomy in the short term and require less medical treatment.