Asetil kolin reseptör antikoru pozitif non-timomatöz myastenia gravis hastalarında timektominin prognoza etkisi

Yıl 2025, Cilt: 50 Sayı: 3, 712 - 720, 30.09.2025

Pınar Bengi Boz , Filiz Koç

https://doi.org/10.17826/cumj.1752659

Öz

Amaç: Bu çalışmada asetil kolin resreptör antikoru pozitif olup timektomi yapılmış Myastenia Gravis hastaların bir yıllık klinik izlem sonuçlarının değerlendirilmesi ve timektominin prognaza etkisisnin araştırılması amaçlanmıştır.
Gereç ve Yöntem: Çalışmaya belirlenen protokole uygun 94 hasta kabul edildi. Değerlendirme, timomatöz olmayan 49 hasta ile devam etti. Hastaların demografik verileri, pre ve post operatif dönemde kullanılan ilaçlar ve dozları, preoperatif dönemde aferez ve intravenöz immün globülin ihtiyacı, varsa miyastenik kriz tablosu ve sayısı, postoperatif hastanede yatış süresi, varsa komplikasyonlar, taburculuk sonrası sağaltım planı, almakta olduğu farmakoterapi ve dozları, timüs patoloji sonuçları, pre ve post- operatif 12. ayda MGFA (Myasthenia Gravis Foundation of America) evreleri karşılaştırmalı olarak değerlendirildi.
Bulgular: Çalışmaya dahil edilen Non-timomatöz hastaların yaş ortalaması 42,52 ± 14,89 yıl olarak belirlenmiştir. Postoperatif hastanede yatış süresi ortalama 6,24 ± 2,70 gün olarak saptanmıştır. postoperatif dönemde preoperatif döneme göre pridostigmin, streoid ve immünsüpresif (azotiopürin) kullanım dozlarının azaldığı belirlenmiştir. Hastaların % 63,3’ünde olumlu klinik sonuç elde edilmiş (MGFA evre 1 ve 2), % 6,1’ inde ise tam klinik remisyon sağlanmıştır.
Sonuç: Bu çalışma, asetil kolin reseptör antikoru pozitif non-timomatöz myastenia gravisli hastalarda timektominin faydasını desteklemekte olup, hem şiddetli hem de hafif myastenia gravis hastalarının timektomiden kısa vadede fayda gördüğünü ve daha az tıbbi tedaviye ihtiyaç duyduğunu göstermektedir.

Anahtar Kelimeler

non-timomatöz myastenia gravis , asetilkolin reseptör antikor , timektomi

Effect of thymectomy on prognosis in non-thymomatous myasthenia gravis patients with acetylcholine receptor antibody positivity

Öz

Purpose: This study aims to evaluate the one-year clinical follow-up outcomes of Myasthenia Gravis patients who are acetylcholine receptor antibody positive and have undergone thymectomy, and to investigate the effect of thymectomy on prognosis.
Materials and Methods: A total of 94 patients meeting the defined protocol were included in the study. Evaluation continued with 49 patients diagnosed with non-thymomatous myasthenia gravis. Demographic data, medications and dosages used in the pre- and postoperative periods, the need for apheresis and intravenous immunoglobulin before surgery, presence and number of myasthenic crises, postoperative hospital stay, complications (if any), post-discharge treatment plan, current pharmacotherapy and dosages, thymus pathology results, and MGFA (Myasthenia Gravis Foundation of America) stages at preoperative and postoperative 12th month were evaluated comparatively.
Results: The mean age of the included non-thymomatous patients was 42.52 ± 14.89 years. The average postoperative hospital stay was 6.24 ± 2.70 days. It was determined that the dosages of pyridostigmine, steroid and immunosuppressive drugs (azothioprine), decreased in the postoperative period compared to the preoperative period. Positive clinical outcomes (MGFA stage 1 and 2) were observed in 63.3% of the patients and complete clinical remission was achieved in 6.1%.
Conclusion: This study supports the benefit of thymectomy in patients with acetylcholine receptor antibody positive non-thymomatous myasthenia gravis, showing that both severe and mild myastenia gravis patients benefit from thymectomy in the short term and require less medical treatment.

Anahtar Kelimeler

thymectomy , non-thymomatous myastenia gravis , acetylcholine receptor antibody

Etik Beyan

Ethical approval was obtained from the Clinical Research Ethics Committee of Adana City Trai-ning and Researche Hospital by its decision dated 10.07.2025 and numbered 15-604.

Destekleyen Kurum

NONE

Kaynakça

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