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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.48 no.1 São Paulo Mar. 1990

http://dx.doi.org/10.1590/S0004-282X1990000100009 

Miastenia grave avaliação crítica dos tratamentos

 

Myasthenia gravis: criticai evaluation of the treatments

 

 

José Lamartine de Assis

Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo (FMUSP): Professor Adjunto. Aula ministrada no Curso Doenças Neuromusculares do 13º Congresso Brasileiro de Neurologia e 13» Reunião da Liga Brasileira de Epilepsia (São Paulo, 24 a 29 de setembro de 1988)

 

 


RESUMO

O autor inicia realçando a dificuldade do tema pois, de um lado, não há certeza acerca do valor dos métodos de tratamento usados em rotina no momento e, de outro, há notória escassez de estudos controlados prospectivos e duplo-cegos. Em grande parte esse dilema decorre da inaplicabilidade, no momento, de métodos específicos de tratamento. A seguir, o autor trata com mais ênfase dos quatro métodos de tratamento mais usados rotineiramente: drogas colinérgicas, timectomia e timomectomia, imunossupressão medicamentosa esteróide e não esteróide e plasmaférese. O tratamento mediante o emprego de anticorpos é referido de modo perfuntório, inclusive a imunoterapia específica experimental com anticorpos e células supressoras. O autor encerra a exposição fazendo avaliação crítica dos métodos de irradiação no tratamento da miastenia grave.


SUMMARY

The author emphasizes the difficulty of the subject since on the one hand there is no assurance about the value of the treatment methods performed commonly at the moment, and on the other hand there is an evident lack of prospectively controlled trials and double-blind studies. Mostly this dilemma occurs by the lack at the moment of any specific treatment. The author deals with the four therapeutic methods most commonly used: colinerglc drugs, thymectomy, immunosuppressive drugs and plasmapheresis. At last, the experimental specific immunotherapy by the use of antibodies and suppressive cells and the irradiation methods are discussed.


 

 

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