Treatment flowchart: Management of MG must be individualised, but this general approach is suitable for most patients. Thymectomy is usually considered in early-onset, anti-AChR-positive MG. Pre-operative immunosuppression (PE or IVIg with or without steroids) might be required, particularly in patients with oropharyngeal or respiratory weakness, but some patients can successfully undergo thymectomy without prior treatment. If a thymoma is discovered, thymothymectomy is a requisite component of early disease management. A course of PE/IVIg can be considered at initiation of chronic immunosuppression to hasten onset of clinical response. | AChR=acetylcholine receptor. IVIg=intravenous immunoglobulin. MG=myasthenia gravis. MUSK=muscle-specific receptor tyrosine kinase. PE=plasma exchange. | Meriggioli, M. N., & Sanders, D. B. (2009). Autoimmune myasthenia gravis: emerging clinical and biological heterogeneity. The Lancet. Neurology, 8(5), 475–490.

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