Graded Response to Thymectomy in Children With Myasthenia Gravis

Abstract

Response to thymectomy in children with juvenile myasthenia gravis was evaluated using severity and response to therapy rating scales and objective measures of hospital, intensive care, and intubation days, prethymectomy and postthymectomy, as markers of morbidity. Records of 50 patients treated for myasthenia gravis at Children's Memorial Hospital, Chicago, were reviewed. Thymectomy was performed in 13 patients; average age was 10 years. Days of intubation, intensive care, and hospitalization were significantly less postthymectomy compared to prethymectomy (P < .0001). Osserman rankings postthymectomy were mild (IIa) in 1, moderate (IIb) in 4, and severe (III) in 1. On a response to therapy scale, 4 patients were grade A (complete remission, no medication); 3 were grade B (improvement, lower drug dosage); 3 were grade C (slight improvement and no change in medication); and 3 were grade D (unchanged). Thymectomy is an effective treatment in 62% of children with myasthenia gravis, and remission is complete in 31%.