Timectomia e imunossupressão em miastenia gravis estudo prospectivo

Abstract

Between 1982 and 1988 24 women and 6 men with myasthenia gravis were included in a prospective and standardized diagnostic and therapeutic protocol. Age varied between 10 and 74 years (34 +/- 16, mean +/- standard deviation). Three patients with the ocular form were treated with pyridostigmine. Four patients with the generalized form and advanced age received steroids and/or azathioprine. Twenty-three patients with the generalized form underwent thymectomy followed by prednisone and/or azathioprine. One patient died after complex thymectomy for invasive thymoma. Another died soon after admission in myasthenic/cholinergic crisis. Two other patients had minor complications of thymectomy. Of 19 patients followed for 1-60 (mean 24) months, 11 (58%) are in remission, one of them without any medication.

Multiple sclerosis: long-term remission after a high dose of cyclophosphamide

“…therapy of relapses with steroids and therapy for prevention of relapses with immune suppressors and immune modulators. We introduced this form of therapy in neurological disorders in Brazil more than 20 years ago (1).…”

“…The use of immune suppression in multiple sclerosis (MS) was described in 1960s, and we introduced the use of azathioprine and cyclophosphamide for neuroimmunological disorders in Brazil in the early 1980s (1,2). In the past few years, an array of so-called Ôdisease-modifyingÕ agents has occupied the front line of therapy, but a significant proportion of cases continue to have relapses.…”