Document Detail


Long-term clinical outcome after extended thymectomy combined postoperative high-dose steroid therapy for juvenile myasthenia gravis.
MedLine Citation:
PMID:  18414352     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Myasthenia gravis (MG) is considered to be an autoimmune disorder of neuromuscular transmission and is rare in childhood. We report 3 juvenile MG (JMG) cases of extended thymectomy (ETMX) combined postoperative high-dose steroid therapy. All patients developed MG symptoms under the age of 14 years and were given cholinergic drugs and had generalized MG: the Myasthenia Gravis Foundation of America classification II was present in 1 case and classification III was in 2. All patients were taking pyridostigmine before surgery; none was treated with prednisone preoperatively. All patients performed the ETMX combined postoperative high-dose steroid therapy. Muscle weakness of extremities and bulbar symptoms improved in all patients, but not all exhibited an unstable phase in their clinical course as a result of combined therapy. There was no postoperative morbidity or mortality. All patients had follicular lymphoid hyperplasia without thymoma. Follow-up for more than 5 years has shown one to be in complete remission and the others to have improved symptoms. Although our results are inconclusive because we used only a few JMG patients, the ETMX combined postoperative high-dose steroid therapy appeared to provide a better chance of remission or control of symptoms.
Authors:
Masato Kanzaki; Tetsuya Obara; Susumu Sasano; Yoshio Hikawa; Takamasa Onuki
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia     Volume:  14     ISSN:  1341-1098     ISO Abbreviation:  Ann Thorac Cardiovasc Surg     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-16     Completed Date:  2008-08-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9703158     Medline TA:  Ann Thorac Cardiovasc Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  119-22     Citation Subset:  IM    
Affiliation:
Department of Thoracic Surgery, Tokyo Metropolitan Fuchu Hospital, Fuchu, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Cholinesterase Inhibitors / administration & dosage
Combined Modality Therapy
Glucocorticoids / administration & dosage*
Humans
Male
Myasthenia Gravis / drug therapy*,  surgery*
Prednisone / administration & dosage*
Pyridostigmine Bromide / administration & dosage
Thymectomy*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cholinesterase Inhibitors; 0/Glucocorticoids; 101-26-8/Pyridostigmine Bromide; 53-03-2/Prednisone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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