In which patients is thymectomy contraindicated for the treatment of myasthenia gravis (MG)?

Updated: Aug 27, 2018
  • Author: Abbas Jowkar, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

Thymectomy is not recommended in patients with antibodies to muscle-specific kinase (MuSK), because of the typical thymus pathology, which is very different from the more common type of MG characterized by seropositivity for AChR antibodies. [53] Current evidence also does not support an indication for thymectomy in patients with LRP4, or agrin antibodies.

Thymectomy may be considered in patients with generalized MG without detectable AChR antibodies if they fail to respond adequately to immunosuppressant therapy, or to avoid/minimize intolerable adverse effects from immunosuppressant therapy.


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