MG: myasthenia gravis; CT: computed tomography; MRI: magnetic resonance imaging; AChR: acetylcholine receptor; MuSK: muscle-specific tyrosine kinase; LRP4: low-density lipoprotein 4.
* Refer to UpToDate topics that review symptomatic treatments (anticholinesterase inhibitors), chronic immunotherapies (glucocorticoids and other immunosuppressive drugs), and rapid immunotherapies (plasma exchange and intravenous immune globulin) for MG.
¶ Patients with MuSK antibody-positive MG do not typically require mediastinal imaging because thymic abnormalities and thymomas are not associated with MuSK antibodies.
Δ Preoperative biopsy is necessary if the anterior mediastinal lesion is not well circumscribed (signs of local infiltration) or if the patient has systemic symptoms that suggest another diagnosis.
◊ For patients with significant preoperative respiratory or bulbar symptoms, treatment with plasmapheresis or intravenous immune globulin is warranted prior to surgery.
§ Symptoms include persistent diplopia in primary gaze or severe bilateral ptosis as well as intolerable adverse effects from pharmacotherapy.Do you want to add Medilib to your home screen?