Effects of thymectomy on multiple sclerosis with myasthenia gravis

Abstract

Multiple sclerosis (MS) is the most common chronic autoimmune neuromuscular disease with prevalence rates that has increased in Iran especially in Isfahan population. In MS, there is a coordinated attack of innate and adaptive immune cell against central nervous system (CNS). Concurrence of autoimmune disorders is prevalent such as the concurrence of MS and myasthenia gravis (MG). MS could be associated with MG although they have different target organs. The aim of this study was to assess the effects of thymectomy as a proper treatment for both MS and MG. We studied patients who were referred to our MS clinic with the diagnosis of definite MS and MG made by a neurologist according to Isfahan MS Clinics, Isfahan, Iran (2010-2013). Age, sex, family and medical history, general neurologic symptoms and physical examination in all patients were recorded. We analyzed the clinical, laboratory, and brain magnetic resonance imaging (MRI) findings of the patients with MS and MG in an attempt to identify parameters involved in these diseases. We surveyed 12 patients (0.3%) out of 3920 patients who had both MS and MG. One of these patients had secondary progressive MS and the others had relapsing-remitting MS (RRMS). Five of them experienced thymectomy operation and about 4 (80%) of them completely improved after thymectomy, none of the symptoms of diseases were seen. Almost all of patients completely improved after thymus removal. We suggest thymectomy could be a valuable therapy for MS/ MG patients. However, more investigations should be done on this issue.