Discordant Thymectomy in Identical Twins Concordant for Myasthenia Gravis
Authors: Kevin R. Riggs, Laurie Gutmann, Jack E. Riggs
Journal: Annals of Internal Medicine (2011)

Letters4 October 2011Discordant Thymectomy in Identical Twins Concordant for Myasthenia GravisKevin R. Riggs, MD, MPH, Laurie Gutmann, MD, and Jack E. Riggs, MDKevin R. Riggs, MD, MPHFrom Duke University School of Medicine, Durham, NC 27710-3182, and West Virginia University School of Medicine, Morgantown, WV 26506-9180.Search for more papers by this author, Laurie Gutmann, MDFrom Duke University School of Medicine, Durham, NC 27710-3182, and West Virginia University School of Medicine, Morgantown, WV 26506-9180.Search for more papers by this author, and Jack E. Riggs, MDFrom Duke University School of Medicine, Durham, NC 27710-3182, and West Virginia University School of Medicine, Morgantown, WV 26506-9180.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-7-201110040-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Thymectomy is standard therapy for nonthymomatous myasthenia gravis despite the absence of randomized clinical trials (1). Myasthenia gravis is uncommonly reported in monozygous twins; disease concordance occurs in approximately one third of such identical twin pairs; and treatment for myasthenia gravis, when described, is usually concordant in identical twin pairs (2).Objective: To report an 11-year clinical course of a pair of identical twins concordant for generalized acetylcholine receptor antibody–positive nonthymomatous myasthenia gravis in whom only 1 was treated with extended transsternal thymectomy.Case Report: Twin A was a 19-year-old white woman who presented with an 8-week history of ...References1. Raica M, Cimpean AM, Ribatti D. Myasthenia gravis and the thymus gland. A historical review. Clin Exp Med. 2008;8:61-4. [PMID: 18618214] CrossrefMedlineGoogle Scholar2. Murphy J, Murphy SF. Myasthenia gravis in identical twins. Neurology. 1986;36:78-80. [PMID: 3941787] CrossrefMedlineGoogle Scholar3. Drachman DB. Myasthenia gravis. N Engl J Med. 1994;330:1797-810. [PMID: 8190158] CrossrefMedlineGoogle Scholar4. Gronseth GS, Barohn RJ. Practice parameter: thymectomy for autoimmune myasthenia gravis (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2000;55:7-15. [PMID: 10891896] CrossrefMedlineGoogle Scholar5. Wolfe GI, Kaminski HJ, Jaretzki A, Swan A, Newsom-Davis J. Development of a thymectomy trial in nonthymomatous myasthenia gravis patients receiving immunosuppressive therapy. Ann N Y Acad Sci. 2003;998:473-80. [PMID: 14592916] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Duke University School of Medicine, Durham, NC 27710-3182, and West Virginia University School of Medicine, Morgantown, WV 26506-9180.Disclosures: Dr. Gutmann: Grants/grants pending (money to institution): Allergan; Royalties: UpToDate; Travel/accommodations/meeting expenses unrelated to activities listed: American Board of Psychology and Neurology. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByGenetic basis of myasthenia gravis – A comprehensive review 4 October 2011Volume 155, Issue 7Page: 478-479KeywordsAcetylcholineImmunosuppressivesMonozygotic twinsMusclesMyasthenia gravisThymectomyThymomaTwins ePublished: 4 October 2011 Issue Published: 4 October 2011 CopyrightCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...