ANALYSIS OF PROGNOSTIC FACTORS IN THYMECTOMIZED PATIENTS WITH MYASTHENIA-GRAVIS - CORRELATION BETWEEN THYMIC LYMPHOID-CELL SUBSETS AND POSTOPERATIVE CLINICAL COURSE

We retrospectively examined the postoperative clinical course of 50 consecutive patients with myasthenia gravis who underwent a transsternal extended thymectomy. Twenty-six patients (52%) showed a steady improving postoperative course without any additional immunotherapy (group A). The remaining 24 patients (48%) had an intractable postoperative course, and most of them needed additional immunotherapy (group B). A significant increases in CD3+ cells, HLA-DR+ cells and B-cells and significant decreases in CD1+ cells and CD8+ cells were observed in the thymuses from patients in group B, compared with the findings in group A. In the peripheral blood, the ratio of CD4+ cells to CD8+ cells was significantly increased in group B. Patients who were either under 40 years of age, females, or without thymoma had good clinical courses after the thymectomy alone.