086 Thymectomy in myasthenia gravis – a review of 36 patients

Abstract

Guidelines set by the Association of British Neurologists recommend thymectomy for patients under the age of 45 with positive AChR antibodies or thymoma. Previous literature supports this, as thymectomy had been shown to improve clinical outcomes and reduce the need for immunosuppressive therapy. However, given the advancement of more successful immunosuppressive medicine the need for thymec- tomy can be questioned.Aim- to identify whether thymectomy aids Myasthenia Gravis (MG) management by reducing the need for immunosuppressive medication.Method- A retrospective evaluation identified 173 patients who had thymectomy in the UHB trust in the past 10 years, from which patients who had a primary indication of MG were extracted. Patient records were reviewed to collate data. Relevant trusts departments were contacted to fill the missing data.Results- 36 patients filled the criteria for inclusion. The average dose of prednisolone had an insignificant reduction by 22mg (STD- 10mg). 16 patients (44%) had a lower dose of prednisolone than prior to surgery. The average dose of Azathioprine had an insignificant increase since surgery by 18mg. There was also a reduction in the use of IVIG and plasma exchange.Conclusion- Thymectomy is unlikely to cause a significant reduction in the need for immunosuppressive therapy. Further research may be required to secure a larger sample size over a longer time period.saiju.jacob@uhb.nhs.uk