Siahaan Yusak M T, Ketaren Retno Jayantri, Pangestu Aristo Rinaldi, Hartoyo Vinson
Neurology Department, Siloam Hospital Lippo Village, Tangerang, Indonesia.
Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia.
Case Rep Neurol. 2021 Jan 7;13(1):1-8. doi: 10.1159/000511300. eCollection 2021 Jan-Apr.
Thymectomy is a common procedure performed in cases of myasthenia gravis (MG) with a thymoma or general MG that does not improve with medical therapy. This procedure is usually preceded by plasmapheresis to prevent the occurrence of myasthenic crisis and improve clinical outcome after thymectomy. Early-onset MG has a different phenotype than late-onset MG. So far, the effectiveness of plasmapheresis followed by thymectomy in early-onset MG remains unclear because of the conflicting results of previous studies. We present 5 early-onset MG patients who underwent plasmapheresis followed by thymectomy in the 2007-2020 period. Follow-up was done 1 year after thymectomy. We describe clinical features and postoperative data and evaluate the clinical outcome after thymectomy. Muscle strength was assessed by the Medical Research Council scale. Evaluation of clinical stage before and after thymectomy were carried out with the modified Osserman classification. All patients showed improvement (100%) in the clinical grade of the modified Osserman classification: 3 patients were in the complete remission category and 2 patients were in the improved category. All patients with general weakness experienced improvement in muscle strength at the 1-year evaluation.
胸腺切除术是一种常见的手术，用于治疗患有胸腺瘤的重症肌无力（MG）患者或药物治疗无效的全身性MG患者。该手术通常在血浆置换之后进行，以预防肌无力危象的发生，并改善胸腺切除术后的临床结局。早发型MG与晚发型MG具有不同的表型。迄今为止，由于先前研究结果相互矛盾，血浆置换后行胸腺切除术在早发型MG中的有效性仍不明确。我们报告了5例在2007年至2020年期间接受血浆置换后行胸腺切除术的早发型MG患者。胸腺切除术后1年进行随访。我们描述了临床特征和术后数据，并评估了胸腺切除术后的临床结局。肌肉力量通过医学研究委员会量表进行评估。胸腺切除术前和术后的临床分期采用改良的奥斯勒曼分类法进行评估。所有患者改良奥斯勒曼分类法的临床分级均有改善（100%）：3例患者处于完全缓解类别，2例患者处于改善类别。所有全身无力的患者在1年评估时肌肉力量均有改善。
