BioMed Research Journal (ISSN:2578-8892)
Abstract
The Favorable Outcome in the Patient with Myasthenia Gravis (MG) after Thymectomy: Case Report, Literature Review
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Myasthenia gravis (MG) is an autoimmune disease that clinically presents with dysarthria, dysphagia, and muscle weakness. The disorder of neuromuscular transmission is caused by an antibody-mediated attack against acetylcholine receptors at neuromuscular junctions. Antiacetylcholine receptor antibodies interfere with the function of acetylcholine at the motor end plate resulting in muscular weakness. The association between myasthenia gravis and thymoma exists.
The treatment of MG involves corticosteroid, immunosuppressive drugs, plasmapheresis, and thymectomy as well. Thymectomy should be considered as a standard treatment even in the absence of thymoma due to leading to significant improvement.
We report the case of a 42-year-old woman who was admitted to Mankweng Hospital with sudden limb weakness, slurring speech, and drooping eyelids for stroke work up. She had no family history of neurological diseases. But she had episode of spiking problems, eyelid weakness, and limb weakness about two year ago when she was admitted for COVID-19 treatment. At that time all above mentioned symptoms were resolved, CT brain was normal. Diagnosis of Transient Ischemic attack (TIA) was established.
On the current admission chest X-ray, CT of the chest were revealed a mediastinal mass suggestive of thymoma. Laboratory investigation confirmed the presence of acetylcholine receptor antibodies in the serum.
She was treated for a month with oral pyridostigmine and prednisolone with partial effect. Then thymectomy was done. During follow up in one month after discharge the patient was still on pyridostigmine Then pyridostigmine was stopped because of dramatic improvement and the absence of myasthenia gravis symptoms, although the follow up was continued.
Keywords: Myasthenia Gravis (MG), Thymoma, Plasmapheresis, Pyridostigmine
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