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

Abstract

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.

Epidemiological Study of Myasthenia Gravis in Patients Referring to Farshchian Hospital in Hamadan

“…iejm.hums.ac.ir http common in women than men (17). More precisely, the prevalence of MG in women is 1.5 times more than that of men (18,19). Furthermore, the incidence of the disease has been reported to be 14 individuals per 100 000 people (20) and its diagnosis may take more than one year.…”

História do estudo da miastenia grave na clínica neurológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

“…A partir da década de 70 o uso rotineiro e intensivo da prednisona pela via oral, acrescido do preparo dos pacientes com corticóide para timectomia, acarretou não só ampliação da indicação da cirurgia como melhora significativa de seus resultados na CNHCFMUSP 12 . Após estudo comparativo de pacientes com e sem preparo pela prednisona 7 , o método com preparo tornou-se rotineiro na CNHCFMUSP, porém com indicação baseada em critérios bem estabelecidos para cada caso A timectomia ainda foi estudada quanto à indicação e resultados em crianças 14 e idosos 15 , tendo sido estabelecidos critérios para indicação nesses grupos etários. Por último, recentemente, foram avaliados os resultados em pacientes acompanhados por períodos de 8 a 25 anos da timectomia versus tratamento conservador, apesar das enormes dificuldades que um estudo dessa natureza acarretou 1012 .…”