RT Journal Article
SR Electronic
T1 Prevalence and risk factors of myasthenia gravis recurrence post-thymectomy
JF Neurosciences Journal
JO Neurosciences (Riyadh)
FD Prince Sultan Military Medical City
SP 4
OP 14
DO 10.17712/nsj.2021.1.20190041
VO 26
IS 1
A1 Alqarni, Fatmah
A1 Almalki, Daifallah
A1 Aljohani, Ziyad
A1 Ali, Abdulrahman
A1 AlSaleem, Alanood
A1 Alotaibi, Noura
A1 Odeh, Shahla
A1 Dalbhi, Sultan Al
YR 2021
UL http://nsj.org.sa/content/26/1/4.abstract
AB Objectives: To evaluate the prevalence and the factors associated with recurrence of myasthenia gravis following thymectomy.Methods: Six electronic databases which reported on recurrence of myasthenia gravis following thymectomy and/or its risk factors from 1985 to 2018 were searched. Summary prevalence and risk values obtained based on the random effect models were reported.Results: Seventy (70) papers containing 7,287 individuals with myasthenia gravis who received thymectomy as part of their management were retrieved. The patients had a mean follow-up of 4.65 years post-thymectomy. The prevalence of myasthenia gravis recurrence post-thymectomy was 18.0% (95% CI 14.7–22.0%; 1865/7287). Evident heterogeneity was observed (I2=93.6%; p<0.001). Recurrence rate was insignificantly higher in male compared with female patients (31.3 vs. 23.8%; p=0.104). Pooled recurrence rates for thymomatous (33.3%) was higher than the rate among non-thymomatous (20.8%) myasthenia gravis patients (Q=4.19, p=0.041). Risk factors for recurrence include older age, male sex, disease severity, having thymomatous myasthenia gravis, longer duration of the myasthenia gravis before surgery, and having an ectopic thymic tissue.Conclusion: A fifth of individuals with myasthenia gravis experience recurrence after thymectomy. Closer monitoring should be given to at-risk patients and further studies are needed to understand interventions to address these risks.