A 25-year-old woman with a 6-month history of diplopia, ptosis worsening throughout the day, and fatigable limb weakness. Anti-AChR antibodies are positive. CT chest reveals thymoma. Which statement about thymectomy is CORRECT per the MGTX trial (2016)?
- A Thymectomy is only beneficial in patients with thymoma and should not be done in non-thymomatous MG
- B Thymectomy improves clinical outcomes and reduces need for immunosuppression even in non-thymomatous AChR+ MG ✓
- C Thymectomy is contraindicated before age 30
- D Thymectomy has no effect on disease course in anti-AChR-positive MG
Correct answer: B. Thymectomy improves clinical outcomes and reduces need for immunosuppression even in non-thymomatous AChR+ MG
Explanation
The MGTX trial (NEJM 2016) demonstrated that extended transsternal thymectomy in non-thymomatous anti-AChR-positive MG led to significantly lower quantitative MG scores, reduced need for immunosuppression, and lower prednisone requirements over 3 years compared to prednisone alone. This established thymectomy as standard of care in generalized AChR+ MG in patients aged 18–65, regardless of whether thymoma is present. Thymoma presence makes thymectomy even more strongly indicated.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.