ArticleEuropean journal of neurology2019
Acquired neuromyotonia in thymoma-associated myasthenia gravis: a clinical and serological study.
Article in European journal of neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 28 citations in OpenAlex.
- Myasthenia Gravis and Thymoma.Muscle & nerve · 2026Review
- Morvan syndrome in a patient with progressing metastatic thymoma and myasthenia gravis.BMJ case reports · 2026Article
- UNC5A IgG in a Previously Reported CASPR2/LGI1-Negative VGKC-Associated Peripheral Nerve Hyperexcitability Syndrome: Long-Term Clinical and Electrophysiological Follow-Up.Case reports in neurological medicine · 2026Article
- Case Report: Dual response to efgartigimod in myasthenia gravis and comorbid autoimmune disorders: a case series.Frontiers in immunology · 2026Article
- Neuromyotonia and CASPR2 Antibodies: Electrophysiological Clues to Disease Pathophysiology.Biomolecules · 2025Review
- Beyond the Surface: Investigating the Potential Mechanisms of Non-Motor Symptoms in Myasthenia Gravis.European journal of neurology · 2025Review
- Neurophysiological Tests in a Myasthenia Gravis Patient With Muscle-Specific Kinase Antibody Accompanied by Myotonic Discharges.Journal of clinical neurology (Seoul, Korea) · 2024Article
- Autoantibodies in neuromuscular disorders: a review of their utility in clinical practice.Frontiers in neurology · 2024Review
- Isaacs' syndrome as the initial presentation of malignant thymoma and associated with double-positive voltage-gated potassium channel complex antibodies, a case report.BMC neurology · 2022Article
- Case report: Complex paraneoplastic syndromes in thymoma with nephrotic syndrome, cutaneous amyloidosis, myasthenia gravis, and Morvan's syndrome.Frontiers in oncology · 2022Article
- Presynaptic Paraneoplastic Disorders of the Neuromuscular Junction: An Update.Brain sciences · 2021Review
- Remission of Thymoma on Steroid Therapy in a Patient With Atypical Thymoma-Associated Multiorgan Autoimmunity: A Case Report and Literature Review.Frontiers in immunology · 2021Review
- Thymoma-associated myasthenia gravis: Clinical features and predictive value of antiacetylcholine receptor antibodies in the risk of recurrence of thymoma.Thoracic cancer · 2021Article
- Cell-based assays for the detection of MOG antibodies: a comparative study.Journal of neurology · 2020Article
- Autoantibody Diagnostics in Neuroimmunology: Experience From the 2018 Italian Neuroimmunology Association External Quality Assessment Program.Frontiers in neurology · 2019Article
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Authors and funding
17 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeAcquired neuromyotonia can occur in patients with thymoma, alone or in association with myasthenia gravis (MG), but the clinical prognostic significance of such comorbidity is largely unknown. The clinico-pathological features were investigated along with the occurrence of neuromyotonia as predictors of tumour recurrence in patients with thymoma-associated myasthenia.
methodsA total number of 268 patients with thymomatous MG were studied retrospectively. Patients with symptoms of spontaneous muscle overactivity were selected for autoantibody testing using immunohistology for neuronal cell-surface proteins and cell-based assays for contactin-associated protein 2 (CASPR2), leucine-rich glioma inactivated 1 (LGI1), glycine receptor and Netrin-1 receptor antibodies. Neuromyotonia was diagnosed according to the presence of typical electromyography abnormalities and/or autoantibodies against LGI1/CASPR2.
resultsOverall, 33/268 (12%) MG patients had a thymoma recurrence. Five/268 (2%) had neuromyotonia, four with typical autoantibodies, including LGI1 (n = 1), CASPR2 (n = 1) or both (n = 2). Three patients had Netrin-1 receptor antibodies, two with neuromyotonia and concomitant CASPR2+LGI1 antibodies and one with spontaneous muscle overactivity without electromyography evidence of neuromyotonia. Thymoma recurrence was more frequent in those with (4/5, 80%) than in those without (28/263, 10%, P < 0.001) neuromyotonia. Neuromyotonia preceded the recurrence in 4/5 patients. In univariate analysis, predictors of thymoma recurrence were age at thymectomy [odds ratio (OR) 0.95, 95% confidence interval (CI) 0.93-0.97], Masaoka stage ≥IIb (OR 10.73, 95% CI 2.38-48.36) and neuromyotonia (OR 41.78, 95% CI 4.71-370.58).
conclusionsDe novo occurrence of neuromyotonia in MG patients with previous thymomas is a rare event and may herald tumour recurrence. Neuronal autoantibodies can be helpful to assess the diagnosis. These observations provide pragmatic risk stratification for tumour vigilance in patients with thymomatous MG.
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