Corticosteroides no tratamento da miastenia grave. Estudo de 12 casos com revisão da literatura

Marchiori

Zambon

et al. 1985

Management of the severe form of myasthenia gravis (MG), by immunosuppression with oral corticosteroids gained impetus during the seventies, with the research carried out in most medical centers that treat this disease 1-13,15,16. Because with rare exceptions 9, controlled trials are few, controversies abound i*. In preparation for thymectomy, immunosuppression with corticosteroids has recently been used 12 » 13 , even though there is no certainty that this improves the results 13.We report the immediate and short-term effects of this management before, during and after thymectomy. MATERIAL. AND METHODSForty patients of both sexes were submitted to thymectomy, but 20 of them received prednisone preoperatively.Characteristics of the disease and other factors were kept as similar as possible in both groups. The immediate and short term results of both groups were compared. By short term is meant the immediate postoperative period and the following two or three weeks. The long term result is up to 6 months after surgery. The age of the group receiving prednisone therapy varied from 9 to 35 years. An average of 22.7 years and standard deviation (sd) of 6.97.Duration of the disease was from 3 months to 13 years with a mean of 3.05and a sd of 3.69 years. The group without previous prednisone therapy varied in age from 16 to 37 years, with an average of 25.25 and sd of 5.12 years. The length of illness was from 6 months to 13 years with an average of 3.52 and sd of 3.16 years.

Immunosupression with corticosteroids and thymectomy in myastenia gravis: an evaluation of immediate and short term results in 20 patients

Marchiori

Zambon

et al. 1985

Miastenia grave: evolução das pesquisas na clínica neurológica do hospital das clínicas da Faculdade de Medicina da USP

1986

Self Cite

Tratamento conservador e timectomia na miastenia grave: resultados avaliados a curto e longo prazos

Marchiori

Zambon

et al. 1987

A retrospective survey of the records of 33 patients with generalized acquired myasthenia gravis treated at Hospital das Clínicas, Medical School of The University of São Paulo, Brazil and in private practice, with and without thymectomy, is reported. Nineteen were thymectomized and 14 non operated. Both groups were demographically homogeneous and were followed from 8 to 24 years. Parameters for evaluating the natural history of disease and other ones for a comparative analysis of the improvement or remissions were established. The influence of the individualized therapy was evaluated by McNemar test (chi 2); the U-Mann-Whitney was used for evaluation of the populational behavior groups; variable parameter with possible influence in the useful life were studied by multivariate analysis. The difference of distance between both groups was not significant: (D2 = 0.08894); T2 = 7.17 (Hottelling test). There were differences of the isolate clinic parameter response in both groups, but the global analysis of the parameters did not permit to discriminate them, possibly because of interaction of the parameters influencing the analytic result. Inspite of the fact that superposition of the parameter occurred when analysed for a long period, we believe the early thymectomy to be beneficial. Our patients who had their operation at a younger age and specially those with recent disease had a maximum improvement.