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Myasthenia gravis treatment: twelve years experience on 110 patients

The Italian Journal of Neurological Sciences volume 8, pages 593–601 (1987)Cite this article

Abstract

The clinical conditions of 110 patients affected by myasthenia gravis (MG) were followed from two to twelve years. Patients with thymectomy showed a statistically higher percentage of clinical remissions than patients without thymectomy. In patients without clinical remission immunosuppressive drugs were prescribed in different schedule; the greater percentage of pharmacological remissions with less adverse effects was obtained with administration of prednisone 50–75 mg/die initially, than gradually reduced to smaller dosage in alternate day, associated to azathioprine. Plasmapheresis, performed in six cases not responders to immunosuppressive drugs, always showed a positive and even prolonged effect.

Sommario

Centodieci pazienti affetti da miastenia grave sono stati sottoposti a controlli clinici ripetuti lungo un periodo variabile da 2 a 12 anni. I pazienti operati di timectomia hanno presentato una percentuale di remissioni cliniche significativamente più elevata rispetto i pazienti non timectomizzati. La grande maggioranza dei pazienti che non hanno manifestato una remissione completa della sintomatologia clinica sono stati sottoposti a diversi programmi di terapia immunosuppressiva. La maggior percentuale di remissioni farmacologiche con minori effetti collaterali fu ottenuta con la somministrazione di una dose iniziale di prednisone di 50–75 mg/die, gradualmente ridotta nelle settimane successive ed infine somministrata a dì alterni, a cui veniva associata, dopo qualche settimana, azatioprina 1–2 mg/Kg/die. La plasmaferesi, eseguita su alcuni pazienti gravemente affetti dalla malattia, e che non rispondevano adeguatamente alle terapie farmacologiche, ha sempre manifestato un effetto positivo, e se ripetuta più volte nello stesso soggetto, anche durevole.

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Affiliations

  1. Clinica Neurologica II, Università di Milano, Policlinico, Via F. Sforza, 35-20122, Milano

    Valli G., Jann S., Premoselli S. & Scarlato G.

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  1. Valli G.
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  2. Jann S.
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  3. Premoselli S.
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  4. Scarlato G.
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This study has been partially supported by “Legato Dino Ferrari”.

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Valli, G., Jann, S., Premoselli, S. et al. Myasthenia gravis treatment: twelve years experience on 110 patients. Ital J Neuro Sci 8, 593–601 (1987). https://doi.org/10.1007/BF02333667

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  • DOI: https://doi.org/10.1007/BF02333667

Key-Words

  • Myasthenia Gravis
  • Themectomy
  • Steroid therapy
  • Immunosuppressive drugs
  • Azathioprine