Spalek P
Neurologická klinika IVZ, NsP Ruzinov, Bratislava.
Rozhl Chir. 1995 Mar;74(2):100-2.
Impaired neuromuscular transmission in myasthenia gravis is caused by autoimmune mechanisms. The association of myasthenia gravis with pathological abnormalities of the thymus has been known for a long time and was the reason why thymectomy was used in the treatment of myasthenia gravis before the immunocompetent impact of the thymus and the autoimmune pathogenesis of myasthenia was known. Forms of myasthenia refractory to thymectomy, and in particular the development of myasthenia gravis after thymectomy on account of a thymoma, indicate the fact that in case of destruction of postsynaptic acetylcholine receptors an important part is played by extrathymic humoral and cellular autoimmune mechanisms. In the submitted paper the authors describe three patients where myasthenia gravis was manifested several months to 14 years after thymectomy on account of a thymoma. The presented facts emphasize the importance of immunosuppressive treatment of patients with myasthenia gravis.
重症肌无力患者神经肌肉传递受损是由自身免疫机制引起的。重症肌无力与胸腺病理异常之间的关联早已为人所知，这也是在人们了解胸腺的免疫活性影响和重症肌无力的自身免疫发病机制之前，胸腺切除术就被用于治疗重症肌无力的原因。对胸腺切除术难治的重症肌无力形式，尤其是因胸腺瘤行胸腺切除术后发生重症肌无力，表明在突触后乙酰胆碱受体被破坏的情况下，胸腺外体液和细胞自身免疫机制起着重要作用。在提交的论文中，作者描述了3例患者，他们因胸腺瘤行胸腺切除术后数月至14年出现重症肌无力。所呈现的事实强调了对重症肌无力患者进行免疫抑制治疗的重要性。
