TITLE:
The Effect of Preoperative AchR-Ab Level to the Prognosis in Operated Myasthenia Gravis Patients
AUTHORS:
Tevfik Ilker Akcam, Ali Ozdil, Onder Kavurmaci, Ayse Gul Ergonul, Kutsal Turhan, Alpaslan Cakan, Ufuk Cagirici, Ayse Nur Yuceyar
KEYWORDS:
AchR-Ab, Myasthenia Gravis, Thymectomy
JOURNAL NAME:
Open Journal of Thoracic Surgery,
Vol.7 No.4,
December
19,
2017
ABSTRACT: Objective: Seropositive myasthenia gravis (MG) depends on the presence of
acetylcholine receptor antibodies (AchR-Ab) against nicotinic acetylcholine
receptors at the postsynaptic neuromuscular junction. In this study, we investigated
the effect of AchR-Ab levels to symptoms and treatment in the MG patients
underwent surgery for thymic pathology. Materilas and Methods: The
records including level of preoperative AchR-Ab, type of thymic pathology, the
changes of symptoms and treatment after surgery for thymic pathology of 37 MG
patients between January 2007 and December 2015 have been viewed
retrospectively. Results: The mean age of 37 patients (21 females, 16
males) was 40.2 ± 14.9 years (range, 18 to 75 years). The mean of the level of
AchR-Ab was 144.7 ± 427.6 nmol/L (range, 0.1 to 1806 nmol/L). In the patient
group including the reduced use of anticholinesterase after surgery the mean of
level of AchR-Ab was 241.3 nmol/L while it was 10.8 nmol/L in the patient group
including the non-reduced use of anticholinesterase (p = 0.082) after a mean follow-up period of 23 months postoperatively. The
mean levels were 246.7 nmol/L and 8.5 nmol/L for the reduced and non-reduced
use of corticosteroid patient groups, respectively (p = 0.001). In the 25 patients with fewer symptom after surgery the mean of
the AchR-Ab level was 205.3 nmol/L while it was 18.3 nmol/L in the patients
without any changes (p = 0.071). Conclusion: We concluded that the preoperative level of
AchR-Ab was associated with postoperative dosage of anticholinesterase and
corticosteroids and severity of symptoms postoperatively. We think that the
levels of AchR-Ab titers can be a marker for the efficacy of thymic surgery.