Roy A, Kalita J, Misra U K, Kar D, Agarwal A, Misra S K
Departments of Neurology and Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India.
Neurol India. 2000 Dec;48(4):343-6.
This study was undertaken to compare the clinical, neurophysiological, radiological and prognostic features of myasthenia gravis with and without thymoma. 37 patients with myasthenia gravis (27 males, 10 females), with age range of 4.5 to 72 (mean 39) years, were managed at a tertiary care centre in India. Four patients were below 15 years of age and 6 above 55 years. Most of the patients were in stage II (34). There were 2 patients in stage III and 1 in stage I. 27 patients underwent thymectomy. Thymoma was detected in 10 cases. The decrement in patients with thymoma ranged between 11 and 62% (mean 27.9%) and nonthymoma group 10-75% (mean 28%). CT scan of thorax revealed mediastinal mass in 5 out of 10 cases of thymoma and 2 out of 27 patients without thymoma. Outcome of myasthenia gravis with thymoma was worse than without thymoma at 1 year followup. Severity of illness, extent of decrement, lack of facilitation, duration of illness and age of the patients were not related to the outcome. It is concluded the clinical and neurophysiological changes in myasthenia gravis with and without thymoma do not differ. However, patients with thymoma have a worse outcome.
本研究旨在比较伴胸腺瘤和不伴胸腺瘤的重症肌无力患者的临床、神经生理学、放射学及预后特征。37例重症肌无力患者（27例男性，10例女性），年龄在4.5至72岁（平均39岁）之间，在印度一家三级医疗中心接受治疗。4例患者年龄低于15岁，6例患者年龄高于55岁。大多数患者处于II期（34例）。III期有2例患者，I期有1例患者。27例患者接受了胸腺切除术。10例患者检测出胸腺瘤。胸腺瘤患者肌无力递减幅度在11%至62%之间（平均27.9%），非胸腺瘤组为10%至75%（平均28%）。胸部CT扫描显示胸腺肿瘤患者中有5例、无胸腺肿瘤患者中有2例存在纵隔肿块。在1年随访中，伴胸腺瘤的重症肌无力患者的预后比不伴胸腺瘤者差。疾病严重程度、递减程度、易化缺乏、病程及患者年龄与预后无关。结论是伴胸腺瘤和不伴胸腺瘤的重症肌无力患者的临床及神经生理学改变无差异。然而，伴胸腺瘤的患者预后较差。
