TY - JOUR A2 - Lisak, Robert P. AU - Romi, Fredrik PY - 2011 DA - 2011/08/10 TI - Thymoma in Myasthenia Gravis: From Diagnosis to Treatment SP - 474512 VL - 2011 AB - One half of cortical thymoma patients develop myasthenia gravis (MG), while 15% of MG patients have thymomas. MG is a neuromuscular junction disease caused in 85% of the cases by acetylcholine receptor (AChR) antibodies. Titin and ryanodine receptor (RyR) antibodies are found in 95% of thymoma MG and 50% of late-onset MG (MG onset ≥50 years), are associated with severe disease, and may predict thymoma MG outcome. Nonlimb symptom profile at MG onset with bulbar, ocular, neck, and respiratory symptoms should raise the suspicion about the presence of thymoma in MG. The presence of titin and RyR antibodies in an MG patient younger than 60 years strongly suggests a thymoma, while their absence at any age strongly excludes thymoma. Thymoma should be removed surgically. Prethymectomy plasmapheresis/iv-IgG should be considered before thymectomy. The pharmacological treatment does not differ from nonthymoma MG, except for tacrolimus which is an option in difficult thymoma and nonthymoma MG cases with RyR antibodies. SN - 2090-0422 UR - https://doi.org/10.4061/2011/474512 DO - 10.4061/2011/474512 JF - Autoimmune Diseases PB - SAGE-Hindawi Access to Research KW - ER -