2026 American Academy of Neurology Abstract Website

Ifat Vigiser¹, Alon Doron², Keren Regev³, Hadar Kolb³, Inbal Friedman-Regev⁴, Amir Bar-Shai⁴, Arnon Karni⁵
¹Neuroimmunology and Multiple Sclerosis Unit, Neurology Institute,, Tel Aviv Medical Center, ²Gray Faculty of Medical & Health Sciences, Tel Aviv University, Israel, ³Neuroimmunology and Multiple Sclerosis Unit, Neurology Institute,, ⁴The institute of Pulmonary Medicine, Tel Aviv Sourasky Medical Center, ⁵Neuroimmunology and Multiple Sclerosis Unit, Neurology Institute, Tel Aviv Sourasky Medical Center, Gray Faculty of Medical & Health Sciences, Tel Aviv University

Objective:

To determine the prevalence, clinical relevance, and risk factors for bronchiectasis in myasthenia gravis (MG).

Background:

MG can cause respiratory muscle weakness and lead to respiratory failure. Comorbid respiratory disease, as bronchiectasis (234/100,000 in Israel), may increase this risk, but its prevalence and relevance in MG remain unclear.

Design/Methods:

We retrospectively analyzed 238 MG patients at Tel Aviv Sourasky Medical Center. BE was confirmed by high-resolution chest CT, and data on demographics, clinical features, and immunology were collected. BE prevalence was also assessed in 111 thymoma patients without MG. Group comparisons used Fisher’s exact test, and logistic regression evaluated the independent and combined effects of MG and thymoma, including interaction terms. ORs with 95% CIs were calculated.

Results:

BE was more frequent in patients with both MG and thymoma (19.6%) compared to MG without thymoma (5.9%, OR 3.9, 95% CI 1.6-9.8, p = 0.0047), thymoma without MG (3.6%, OR 6.5, 95% CI 1.9-22, p = 0.0016), and the general population (0.23%). ORs for BE were significantly elevated in all subgroups compared to the general population: 104.0 (95% CI 51.5-210.0, p = 7.2 × 10⁻¹⁷), 26.6 (95% CI 14.3-49.7, p = 1.9 × 10⁻¹²), and 15.9 (95% CI 5.8-43.6, p = 1.5 × 10⁻⁴), respectively. Bulbar symptoms were not associated with BE (p=0.500). MG and thymoma were independently associated with BE, but a negative interaction term (β = -1.41, p = 0.043) suggested overlapping mechanisms. BE was associated with increased risk of myasthenic crisis (30.4% vs. 6.7%, OR = 6.1, p = 0.002), especially in the presence of thymoma (60% vs. 8.3%, OR = 16.5, p = 0.020).

Conclusions:

Bronchiectasis is an underrecognized but clinically relevant comorbidity in MG, particularly with thymoma, forming a triad associated with a high-risk disease phenotype. Its presence may reflect an autoimmune-mediated form of BE linked to the MG-thymoma spectrum.