In myasthenia gravis, thymectomy is recommended in which clinical scenario according to current MGFA/AAN guidelines?

• A All AChR antibody-positive patients regardless of thymoma status
• B Seronegative MG with predominant ocular features
• C MuSK antibody-positive MG in all age groups
• D Patients aged 18–65 with non-thymomatous AChR antibody-positive generalised MG (based on MGTX trial evidence) ✓

Explanation

The MGTX randomised trial (2016) demonstrated that extended transsternal thymectomy in non-thymomatous AChR antibody-positive generalised MG patients aged 18–65 significantly improved 3-year outcomes (minimal manifestation status and reduced prednisone requirements). Thymectomy is also mandatory in thymoma regardless of MG symptoms. Seronegative (ocular) MG and MuSK-positive MG are not currently supported by evidence for routine thymectomy.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.