Preoperative High-Dose Steroid Has Long-Term Beneficial Effects for Myasthenia Gravis
نویسندگان
چکیده
Previous studies addressing preoperative steroid treatment have revealed that control of myasthenia gravis (MG) with steroids prior to surgery appeared to stabilize postoperative status. The purpose of our study was to clarify the clinical benefits of the preoperative programmed high-dose steroid treatment on the long-term outcomes of MG patients. We retrospectively reviewed the records of 171 MG patients who were followed up after undergoing thymectomy in our hospital between 1988 and 2006. One hundred and thirteen patients in the programmed treatment group had received preoperative steroid treatment, while 58 patients received no steroid treatment during the preoperative period. Clinical remission, which was defined as the achievement of the modified pharmacologic remission (PR) for at least 1 year, and clinical benefits were compared between the two groups. With regard to the remission after thymectomy, Kaplan-Meier life-table curves for patients in the preoperative steroid treatment group versus those for patients in the no steroid preoperative treatment group revealed a significantly higher probability of the PR in the preoperative steroid treatment group (log-rank test, P < 0.01). This study might be the first, as per our knowledge, to indicate that preoperative programmed high-dose steroid treatment has long-term beneficial effects for MG patients.
منابع مشابه
Low-Dose Steroid after Thymectomy in Myasthenia Gravis: Is It a Complete Solution for Postoperative Respiratory Insufficiency?
in the impairment of the standardization and influence rate of postoperative insufficiency. Third, preoperative physostigmine doses used and preoperative respiratory function tests are related directly to the PRI in Myasthenia Gravis patients. Reporting of this data is also needed to evaluate PRI thoroughly. Fourth, another important data that is directly related to PRI is the anesthesia techni...
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A case of myasthenia gravis in a 15 years old girl is pre·sented. The disease was present for 5 years before thymectomy was performed. Indications for thymectomy, preoperative preparation, anesthetic and surgical management is -discussed.
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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 Ameri...
متن کاملSupplemental factors including those associated with anesthesiology for respiratory insufficiency after thymectomy in generalized myasthenia gravis.
regard to the surgical technique, the number of surgeons differed between the steroid use group (one surgeon) and the steroid nonuse group (four surgeons) [1] . The preoperative use of acetylcholinesterase, which can induce respiratory insufficiency [2] , which was slightly but not significantly higher in the steroid nonuse group (80%) than in the steroid use group (62%). The preoperative vital...
متن کاملOutcome of thymectomy in patients with Myasthenia Gravis.
OBJECTIVE Myasthenia Gravis is a neuromuscular disorder characterized by weakness and fatigability of skeletal muscles. Thymectomy is now beneficial even for non-thymomatous patients. The aim of this paper is to evaluate the role of thymectomy as on the treatment options for myasthenia gravis. METHODS Thirty patients underwent thymectomy in the period from April 1999 through to July 2000. The...
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عنوان ژورنال:
دوره 2013 شماره
صفحات -
تاریخ انتشار 2013