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THE JOURNAL OF CARDIOVASCULAR SURGERY

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The Journal of Cardiovascular Surgery 1999 December;40(6):893-5

lingua: Inglese

Extended thy­mec­tomy for myas­thenia ­gravis in an octo­ge­narian. A ­case ­report

Hamada Y., Sakai Y., Ito H., Ichikawa H., Morishita Y.

From the Depart­ment of ­Chest Sur­gery Depart­ment of Neu­rology and Depart­ment of ­Pathology Mae­bashi Red ­Cross Hos­pital and Second Depart­ment of Sur­gery
­Gunma Uni­ver­sity ­School of Med­i­cine, Mae­bashi, ­Japan


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An 86-­year-old ­woman ­with myas­thenia ­gravis suc­cess­fully under­went an ­extended thy­mec­tomy. The ­patient had a 2-­year his­tory of gen­er­al­ized myas­thenia and had lim­ited ­response to anti­chol­i­nes­te­rases and ster­oids. An ­extended thy­mec­tomy was suc­cess­fully per­formed in the ­usual ­fashion. The post­op­er­a­tive ­course was ­uneventful ­except for an epi­sode of psy­chosis prob­ably due to post­op­er­a­tive ­steroid ­therapy. The ­steroid ­dosage was grad­u­ally ­reduced to 5 mg/day ­over ­seven ­months ­after the oper­a­tion, ­during ­which she ­became ­fully asymp­to­matic. No symp­toms due to myas­thenia ­have sur­faced for ­over 2 ­years ­after sur­gery. ­Although eld­erly ­patients are usu­ally con­sid­ered to be ­less respon­sive to an oper­a­tion, thy­mec­tomy may some­times be the treat­ment of ­choice for myas­thenia ­gravis ­even in octo­ge­nar­ians.

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