The magic gland

Some things seem to be real only when we are children and tend to disappear by the time we become adults. Thymus gland may be one of them. It grows until puberty and then begins to involute in size and activity as we age. At least it is supposed to unless something goes wrong along the process. For instance, if thymus gland gives incorrect ‘instructions’ to immune cells this sometimes results in autoimmunity. For MG which is an autoimmune disease this means the production of the acetylcholine receptor antibodies which attack the neuromuscular transmission and cause fatigue and weakness in voluntary muscles.

I have to admit that I haven’t heard of thymus before being diagnosed with MG. It seems to be strongly related to MG although the connection between the two remains unclear. Most of the individuals with MG have abnormally large thymus glands which need to be removed before they progress into a tumour called thymoma (which sometimes can be cancerogenous). The surgical removal of the thymus gland is called thymectomy. This procedure proved to significantly reduce symptoms in individuals with MG (with or without thymomas). Some research claims that 70% of patients undertaking thymectomy reported reduced symptoms or even complete remission after a number of months/years.

Shortly after I have been diagnosed I was referred for a CT for chest (where this gland is located – just below the neck, behind the breastbone and in front of the heart). I have just received the results and I am not sure whether it is good or bad news... I just take them as they come in a detach way most of the time. The scan has NOT shown any particular abnormalities or at least not to the extent that requires surgery: "CT scan of the chest shows a small degree of tissue in the anterior mediastinum. This may simply represent a small remnant of thymus gland. Whether it is relevant to his symptoms of myasthenia is unclear. Certainly with myasthenia limited to the ocular muscles we wouldn't tend to advocate thymectomy...". However I have read about people with MG who had their thymus gland removed even if it wasn't enlarged (or at least wasn't visible on CT/MRI scans). I don’t even want to think about it right now as I need to work out my beach body for my exotic holidays later this year! Leaving the joke aside, I definitely have to ask more questions about this (and many other things) during my next appointment with my neurologist in a couple of weeks…