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

Assis, J. Lamartine de; Marchiori, Paulo E.; Zambon, Antonio A.; Curi, Nagib; Filomeno, Luiz Tarcisio Brito; Scaff, Milberto

doi:10.1590/S0004-282X1985000100003

Abstracts

A comparatice study was conducted on two groups of patients with the generalized severe form of myasthenia gravis. The first group of 20 patients received oral daily doses of 60-100 mg of prednisone prior to thymectomy. The control group of 20 were submitted to surgery without prior corticosteroid treatment. The study included statistical analysis of the clinical results and surgical complications for both groups. The author concluded that the use of steroids preoperatively is beneficial.

São apresentados os resultados da timectomia em 20 pacientes com miastenia grave generalizada, a maioria severa, e tratados previamente com prednisona em doses altas (60-100mg, diariamente) por via oral. Os resultados foram comparados aos de um grupo de 20 pacientes muito semelhantes aos primeiros quanto à idade, sexo e forma clínica da doença, mas sem preparo prévio com prednisona. Os autores concluem que os resultados da timectomia nos pacientes tratados ou não com prednisona são semelhantes. Entretanto, aqueles submetidos ao preparo prévio com o corticóide tiveram menos complicações no pós-operatório imediato e mediato do que os do grupo controle. As diferenças foram estatisticamente significantes.

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

Imunossupressão com corticosteróides e timectomia na miastenia grave: avaliação dos resultados em 20 pacientes a curto e médio prazos

J. Lamartine de Assis^I; Paulo E. Marchiori^II; Antonio A. Zambon^II; Nagib Curi^III; Luiz Tarcisio Brito Filomeno^II; Milberto Scaff^IV

^IProfessor Adjunto. Department of Surgery and the Department of Neuropsychiatry, University of São Paulo Medical School

^IIMédico Assistente. Department of Surgery and the Department of Neuropsychiatry, University of São Paulo Medical School

^IIIProfessor Assistente Doutor. Department of Surgery and the Department of Neuropsychiatry, University of São Paulo Medical School

^IVProfessor Livre-Docente. Department of Surgery and the Department of Neuropsychiatry, University of São Paulo Medical School

SUMMARY

A comparatice study was conducted on two groups of patients with the generalized severe form of myasthenia gravis. The first group of 20 patients received oral daily doses of 60-100 mg of prednisone prior to thymectomy. The control group of 20 were submitted to surgery without prior corticosteroid treatment. The study included statistical analysis of the clinical results and surgical complications for both groups. The author concluded that the use of steroids preoperatively is beneficial.

RESUMO

São apresentados os resultados da timectomia em 20 pacientes com miastenia grave generalizada, a maioria severa, e tratados previamente com prednisona em doses altas (60-100mg, diariamente) por via oral. Os resultados foram comparados aos de um grupo de 20 pacientes muito semelhantes aos primeiros quanto à idade, sexo e forma clínica da doença, mas sem preparo prévio com prednisona. Os autores concluem que os resultados da timectomia nos pacientes tratados ou não com prednisona são semelhantes. Entretanto, aqueles submetidos ao preparo prévio com o corticóide tiveram menos complicações no pós-operatório imediato e mediato do que os do grupo controle. As diferenças foram estatisticamente significantes.

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1. ASSIS, J.L. - Corticosteroides no tratamento da miastenia grave. Estudo de 12 casos com revisão da literatura. Arq. Neuro-Psiquiat. ( São Paulo) 33:33, 1975.
2. ASSIS, J.L. & CURI, N. - Timectomia na miastenia grave. Avaliação dos resultados em 73 pacientes. Arq. Neuro-Psiquiat. (São Paulo) 36:16, 1978.
3. BOLOOKI, H. & SCHWARTZMAN, R.J. - Role of steroids in management of patients with myasthenia gravis undergoing thymectomy. J. thorac. Surg. 75:754, 1978
4. BRUNNER, N.G.; NAMBA, T. & GROB, D. - Corticosteroids in management of severe, generalized myasthenia gravis. Neurology (Minneapolis) 22:603, 1972.
5. BRUNNER, N.G.; BERGER, C.L.; NAMBA, T. & GROB, D. - Corticotropin and corticosteroids in generalized myasthenia gravis. Comparative studies and role in management. Ann. N.T. Acad. Sci. 274:577, 1976.
6. CLARK, R.E.; MAREARGER, J.P.; WEST, P.N.; SPRATT, J.A.; FLORENCE, J.M.; ROPER, C.L.; FERGUSON, T.B. & WELDON, C.S. - Thymectomy for myasthenia gravis in the young adult. J. thorac. Surg. 80:696, 1980.
7. ENGEL, W.K. - Mysthenia gravis. Ann. int. Med. 81:225, 1974.
8. ENGEL, W.K. - Myasthenia gravis, corticosteroids, anticholinesterases. Ann. N.Y. Acad. Sci. 274:623, 1976.
9. HOWARD, F.N.; DUANE, D.D.; LAMBERT, F.H. - Alternate day prednisone: preliminary report of a double-blind controlled study. Ann. N.Y. Acad. Sci. 274:596, 1976.
10. JOHNS, T.R.; MANN, J.D.; JOSEPH, B.S. & CAMPA, J.F. - Longterm administration of corticosteroids in myasthenia gravis. Neurology (Minneapolis) 22:400, 1972.
11. KJAER, M. - Myasthenia gravis and myasthenic syndromes treated with prednisone. Acta neurol. scand. 47:464, 1971.
12. MANN, J.D.; CAMPA, J.F.; MULLER, W.H. - Long-term prednisone followed by thymectomy in myasthenia gravis. Ann. N.Y. Acad. Sci. 274:608, 1976.
13. MINTZ, J.; PETERSEN, S.R.; MacFARLAND, D.; PETAJAN, J.; RICHARDS, R.C. - The current role of thymectomy for myasthenia gravis. Amer. J. Surg. 140:734, 1980.
14. ROWLAND, L.P. - Controversies about the treatment of myasthenia gravis. J. Neurol. Neurosurg. Psychiat. 43:644, 1980.
15. SEYBOLD, M.E.; DRACHMAN, D.B. - Gradually increasing doses of prednisone in myasthenia gravis: reducing the hazards of treatment. N. Engl. J. Med. 290: 81, 1974.
16. WARMOLTS, J.R.; ENGEL, W.K. - Benefit from alternate day prednisone in myasthenia gravis. N. Engl. J. Med. 286:17, 1972.

Publication Dates

Publication in this collection
13 Aug 2012
Date of issue
Mar 1985

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ASSIS, J.L. - Corticosteroides no tratamento da miastenia grave. Estudo de 12 casos com revisão da literatura. Arq. Neuro-Psiquiat. ( São Paulo) 33:33, 1975.

[2] 2. ASSIS, J.L. & CURI, N. - Timectomia na miastenia grave. Avaliação dos resultados em 73 pacientes. Arq. Neuro-Psiquiat. (São Paulo) 36:16, 1978.

[3] 3. BOLOOKI, H. & SCHWARTZMAN, R.J. - Role of steroids in management of patients with myasthenia gravis undergoing thymectomy. J. thorac. Surg. 75:754, 1978

[4] 4. BRUNNER, N.G.; NAMBA, T. & GROB, D. - Corticosteroids in management of severe, generalized myasthenia gravis. Neurology (Minneapolis) 22:603, 1972.

[5] 5. BRUNNER, N.G.; BERGER, C.L.; NAMBA, T. & GROB, D. - Corticotropin and corticosteroids in generalized myasthenia gravis. Comparative studies and role in management. Ann. N.T. Acad. Sci. 274:577, 1976.

[6] 6. CLARK, R.E.; MAREARGER, J.P.; WEST, P.N.; SPRATT, J.A.; FLORENCE, J.M.; ROPER, C.L.; FERGUSON, T.B. & WELDON, C.S. - Thymectomy for myasthenia gravis in the young adult. J. thorac. Surg. 80:696, 1980.

[7] 7. ENGEL, W.K. - Mysthenia gravis. Ann. int. Med. 81:225, 1974.

[8] 8. ENGEL, W.K. - Myasthenia gravis, corticosteroids, anticholinesterases. Ann. N.Y. Acad. Sci. 274:623, 1976.

[9] 9. HOWARD, F.N.; DUANE, D.D.; LAMBERT, F.H. - Alternate day prednisone: preliminary report of a double-blind controlled study. Ann. N.Y. Acad. Sci. 274:596, 1976.

[10] 10. JOHNS, T.R.; MANN, J.D.; JOSEPH, B.S. & CAMPA, J.F. - Longterm administration of corticosteroids in myasthenia gravis. Neurology (Minneapolis) 22:400, 1972.

[11] 11. KJAER, M. - Myasthenia gravis and myasthenic syndromes treated with prednisone. Acta neurol. scand. 47:464, 1971.

[12] 12. MANN, J.D.; CAMPA, J.F.; MULLER, W.H. - Long-term prednisone followed by thymectomy in myasthenia gravis. Ann. N.Y. Acad. Sci. 274:608, 1976.

[13] 13. MINTZ, J.; PETERSEN, S.R.; MacFARLAND, D.; PETAJAN, J.; RICHARDS, R.C. - The current role of thymectomy for myasthenia gravis. Amer. J. Surg. 140:734, 1980.

[14] 14. ROWLAND, L.P. - Controversies about the treatment of myasthenia gravis. J. Neurol. Neurosurg. Psychiat. 43:644, 1980.

[15] 15. SEYBOLD, M.E.; DRACHMAN, D.B. - Gradually increasing doses of prednisone in myasthenia gravis: reducing the hazards of treatment. N. Engl. J. Med. 290: 81, 1974.

[16] 16. WARMOLTS, J.R.; ENGEL, W.K. - Benefit from alternate day prednisone in myasthenia gravis. N. Engl. J. Med. 286:17, 1972.