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Thymus changes in anti-MuSK-positive and -negative myasthenia gravis

From the Departments of Pathology, General Pathology (Dr. Bartoccioni), and Neurosciences (Drs. Punzi, Marsili, and Evoli), Catholic University, Rome, Italy.

Address correspondence and reprint requests to Dr. A. Evoli, Neuroscience Department, Catholic University, L.go F. Vito,1 – 00168 Rome, Italy; e-mail: a.evoli{at}rm.unicatt.it

Morphologic findings of thymuses from 32 anti-acetylcholine receptor (AChR)-negative myasthenia gravis patients, 12 with and 20 without antibodies against the muscle-specific kinase (MuSK), were compared with those from 30 AChR-positive subjects. In contrast with the high frequency of thymic hyperplastic changes in AChR-positive patients, in MuSK-positive subjects histologic alterations were minimal, arguing against an intrathymic disease pathogenesis. Since hyperplastic changes were seen in 35% of MuSK-negative patients, the thymus could be involved in some of these cases.

Received July 23, 2004. Accepted in final form September 8, 2004.

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