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NEUROLOGY 1992;42:586
© 1992 American Academy of Neurology

Seronegative generalized myasthenia gravis

Low frequency of thymic pathology

Pradeep K. Verma, MD and Joel J-F. Oger, MD, FRCP(C)

Division of Neurology, University of British Columbia, Vancouver, BC, Canada.

We have reviewed thymus histology, preoperative serum acetylcholine receptor antibody status, and clinical features of all 50 patients who underwent thymectomy for generalized myasthenia gravis in the University of British Columbia-affiliated hospitals over the last 8 years. Seven patients had thymoma, 25 had hyperplasia, and 18 had a normal thymus. The seven thymoma patients all had severe limb involvement and all had circulating antibodies against the acetylcholine receptor. Patients without circulating antibodies had only minimal limb involvement and half of them had a normal thymus. Only two of the 32 (6%) patients with abnormal thymus were antibody-negative; this contrasts with six of the 18 patients (33%) with normal thymus. We conclude that seronegative patients with generalized myasthenia gravis constitute a distinct subgroup which may not be immunologically homogeneous and could be subgrouped with normal or abnormal thymic histology.

Address correspondence and reprint requests to Dr. Joel Oger, Department of Medicine, Division of Neurology, University Hospital UBC site, 2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5.

Dr. P.K. Verma is recipient of the Ruth Aziz fellowship from the Muscular Dystrophy Association of Canada.

Received January 2, 1991. Accepted for publication in final form August 13, 1991.




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