Mizutani S, Nakaoka K, Ohno K, Hayakawa M, Nishiyama M, Hasegawa J
Department of Respiratory Surgery, Kure National Hospital, Hiroshima, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Feb;39(2):228-31.
We experienced a case of late-onset myasthenia gravis associated with Hashimoto's disease. A 74-year-old female with chief complaints of extremities acratia and hypohidrosis was diagnosed as having myasthenia gravis by the Tensilon test. In addition severe hypothyroidism was noted, and histological examination of a thyroid biopsy revealed Hashimoto's thyroiditis. Extended thymectomy was carried out, and the postoperative course was uneventful due to administration of an anti-ChE drug and a thyroid hormone. This case is extremely rare because only 10 patients with late-onset (over 70 years old) myasthenia gravis have been reported in the literature in Japan, and only three of them were associated with Hashimoto's disease. It was suggested that, in cases of myasthenia gravis in elderly patients, we should take into consideration radical therapy including thymectomy as a positive approach to treatment.
我们遇到一例与桥本氏病相关的迟发性重症肌无力病例。一名74岁女性,主要症状为肢体无力和少汗,通过腾喜龙试验被诊断为重症肌无力。此外,还发现严重甲状腺功能减退,甲状腺活检组织学检查显示为桥本氏甲状腺炎。实施了扩大胸腺切除术,术后通过使用抗胆碱酯酶药物和甲状腺激素,病情平稳。该病例极为罕见,因为在日本文献中仅报道了10例迟发性(70岁以上)重症肌无力患者,其中仅有3例与桥本氏病相关。这表明,对于老年重症肌无力患者,我们应考虑将包括胸腺切除术在内的根治性治疗作为积极的治疗方法。