TPOAb + TgAb + MG exhibited a severe phenotype: higher MGFA III (30.8 %), relapsed (71.8 % vs 50.0 % in TPOAb-TgAb-, P = 0.030), thymoma (43.6 %), and TitinAb/RyRAb positivity (43.6 %/25.6 %). The gene discussed is MGAM; the disease is thymoma.