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Myasthenia gravis treatment: twelve years experience on 110 patients

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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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Authors and 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

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