Results of thymectomy in systemic lupus erythematosus: observations on clinical course and serological reactions.

1. Thymectomy was performed as a treatment of severe systemic lupus erythematosus in three females aged 20, 14 and 56 years: two of these had not received corticosteroids pre-operatively. 2. There was no immediate improvement post-operatively, and full treatment with corticosteroids was required in each case. 3. All three patients remained in moderate to good health, with few hospital admissions over observation periods of 1–3 years. 4. In two cases negative Coombs and antithyroglobulin tests became transiently positive after thymectomy. 5. Thymectomy had no effect on the titre of antinuclear autoantibody, which remained high throughout the period of observation in all patients. 6. The post-operative fall in titre of anticytoplasmic antibody (AICF reaction) was considered to be an effect of prednisolone. 7. Thymectomy as a treatment of autoimmune diseases other than myasthenia gravis may be effective only in childhood when any proliferative process involving lymphoid cells would be predominantly active in the thymus and thymectomy could be expected to remove a highly significant fraction of that activity.