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Autoimmune neurological disease after cardiac surgery

¹ Cardiothoracic Centre, St Thomas’ Hospital, London, UK
² Neurosciences Group, Weatherall Institute of Molecular Medicine, Oxford, UK

Correspondence to:
Correspondence to:
Professor A Vincent;
angela.vincent@imm.ox.ac.uk

Keywords: autoantibodies; autoimmunity; myasthenia; thoracic surgery; thymus

The first 150 words of the full text of this article appear below.

A recent report on three patients who developed myasthenia gravis (MG) three to 10 weeks after cardiac surgery¹ raised the intriguing possibility that thoracotomy, by damaging the thymus, could precipitate MG. MG is an autoimmune disorder, associated with autoantibodies that bind to the acetylcholine receptor (AChR) or to muscle specific kinase (MuSK) at the neuromuscular junction. The thymus gland is clearly involved in the aetiology of some cases of MG, probably because the thymic "myoid" cells express acetylcholine receptors.² In the increasing number of older MG patients,³ however, the cause of the disease is not clear.

Voltage gated potassium channels (VGKCs) are also expressed in the thymus.⁴ Antibodies to VGKCs have recently been found in some patients with unexplained amnesia,⁵ and memory loss is common after cardiac surgery, occurring in up to 75% of patients.

For these reasons, we tested sera from 50 persons before and six weeks after cardiac . . . [Full text of this article]