Goto Tamako, Mori Masato, Yamagata Takanori, Mizuguchi Masashi, Momoi Mariko Y
Department of Pediatrics, Jichi University, Shimotsuke, Tochigi.
No To Hattatsu. 2007 Jul;39(4):300-3.
A 7-year-old girl was diagnosed with generalized myasthenia gravis and became steroid-dependent. Dose of prednisolone could not be reduced to < 2 mg/kg/day on alternate days, despite adverse effects. Thymectomy was avoided. Oral tacrolimus was initiated at 1.0 - 1.3 mg/kg/day. Ptosis and weakness of the lingual and pharyngeal muscles began to ameliorate 2 weeks later, and disappeared within 2 months. Serum titer of anti-acetylcholine receptor antibody also declined. During the subsequent two years, remission was maintained although prednisolone was reduced to half the original dose. No adverse effects of tacrolimus were noted. This case suggests the usefulness of tacrolimus in the treatment of childhood myasthenia gravis.
一名7岁女孩被诊断为全身型重症肌无力，且对类固醇产生依赖。尽管有不良反应，但泼尼松龙的剂量无法隔日减至<2mg/kg/天。避免了胸腺切除术。开始口服他克莫司，剂量为1.0 - 1.3mg/kg/天。2周后上睑下垂以及舌肌和咽肌无力开始改善，并在2个月内消失。抗乙酰胆碱受体抗体的血清滴度也下降。在随后的两年中，尽管泼尼松龙减至原剂量的一半，但仍维持缓解状态。未观察到他克莫司的不良反应。该病例提示他克莫司在儿童重症肌无力治疗中有用。
