Post‐thymomectomy myasthenia gravis

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Abstract
A 68-year-old male first developed ocular myasthenia gravis 2 mo. after total removal of a thymoma which had been present for at least 7 yr. The recent clinical observations and immunologic investigations which suggest that myasthenia gravis is an autoimmune disorder and that the thymus is an immunologic organ are reviewed. Other reports of post-thymomectomy myasthenia gravis are summarized. In 15 cases so far reported, clinical onset of myasthenia gravis followed total removal of a benign thymoma. In 13 of these cases, it is un-likely that anesthesia at the time of surgery precipitated the clinical symptoms, which did not appear until a few weeks to 4 yr. following the total thymomectomy. Certain features of myasthenia gravis in relation to thymic changes can be explained by assuming production as well as inhibition of self-reactive cells in the thymus. The un-usual clinical onset of post-thymomectomy myasthenia may well be due to removal of inhibition of self-reactive cells by thymomectomy.

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