Thymectomy in Juvenile Myasthenia Gravis

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Abstract
The clinical course of juvenile patients with myasthenia gravis seen at the Mayo Clinic through 1965 was reviewed. The current status of 102 of the 105 patients was determined, with an average follow-up of 16.1 years. Of those treated wtih thymectomy, 37.5% were in remission and 18.8% died. Of those who did not have thymectomy, 24.1% were in remission and 20.4% died. The outcome was similar in a subseries of children with onset of myasthenia gravis prior to puberty. These results suggest, but fail to prove, the effectiveness of thymectomy in inducing remission or decreasing the mortality rate. Multiple potential biases in this study are recognized. Operation within two years of the onset resulted in a higher remission rate, but no correlation between remission and the degree of thymic hyperplasia was observed.