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Neuromyelitis optica in patients with myasthenia gravis who underwent thymectomy
Ilya Kister1, Sandeep Gulati, Cavit Boz
1Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10467, USA.
Background:
Myasthenia gravis (MG) and neuromyelitis optica (NMO, also known as Devic disease) are rare autoimmune disorders, with upper-limit prevalence estimates in the general population of 15 per 100,000 and 5 per 100,000, respectively. To our knowledge, an association between these diseases has not been previously reported.
Objectives:
To describe 4 patients with MG who developed NMO after thymectomy and to analyze possible causes of apparent increased prevalence of NMO among patients with MG.
Design:
Case series.
Patients:
Four patients with MG who underwent thymectomy.
Interventions:
None.
Results:
The prevalence of MG within the published cohort of patients with NMO is more than 150 times higher than that in the general population.
Conclusion:
Dysregulation of B-cell autoimmunity in myasthenia, possibly exacerbated by loss of control over autoreactive cells as a result of thymectomy, may predispose patients to the development of NMO.
Insights
This study reports four cases of myasthenia gravis (MG) patients who developed neuromyelitis optica (NMO) after thymectomy. This suggests thymectomy may increase NMO risk in MG patients.
Area of Science:
- Neurology
- Immunology
- Autoimmune Diseases
Background:
- Myasthenia gravis (MG) and neuromyelitis optica (NMO) are rare autoimmune disorders.
- The association between MG and NMO has not been previously reported.
Observation:
- Four patients with MG developed NMO following thymectomy.
- The prevalence of MG in NMO patients is significantly higher than in the general population.
Findings:
- Thymectomy may be a risk factor for NMO development in MG patients.
- Dysregulation of B-cell autoimmunity in MG, potentially worsened by thymectomy, could predispose to NMO.
Implications:
- This research highlights a potential link between thymectomy and NMO in MG patients.
- Further investigation is warranted to understand the mechanisms underlying this association and inform clinical practice.
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