Essa Mohamed, El-Medany Yasser, Hajjar Waseem, Hariri Zohair, Al-Mulhim Faisal, Salih Mustafa, Ashour Mahmoud, Al-Kattan Khaled
Thoracic Surgery Unit, Department of Surgery, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh 11472, Saudi Arabia.
Eur J Cardiothorac Surg. 2003 Aug;24(2):187-9; discussion 190-1. doi: 10.1016/s1010-7940(03)00299-9.
We performed this study to evaluate the benefit of thymectomy in children with myasthenia gravis (MG).
Over a period of 15 years from 1986 to 2001, we collected data on 30 children with MG and retrospectively reviewed the outcome of maximal thymectomy.
There were 23 females and seven males with a mean age of 13.2 years (range 4-16). The mean duration of the disease was 19.3 months (range 2-144). According to Osserman classification, there were 14 children in class II; 12 in class III; and four children in class IV. One child in class IV required postoperative ventilation and one was re-explored to drain a pericardial effusion secondary to central line leak. We found ectopic thymic tissue in 10 cases (33.3%). During a mean follow-up period of 53.5 months (range 9-180), complete remission was noted in 13 children (43.4%) and improvement in 14 (46.6%). The remaining three children (10%) did not improve following surgery. Univariate analysis (P < 0.05) showed that ectopic thymic tissue is a significant prognostic factor for outcome.
Maximal thymectomy appears to provide a high rate of remission and improvement in children with MG. However, the presence of ectopic thymic tissue has poor prognostic value.
