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Results of surgical treatment for juvenile myasthenia gravis

Abstract:

Introduction Radical or extended thymectomy is an effective treatment for myasthenia gravis in the adult population. There are few reports to demonstrate the effectiveness of this treatment in patients with juvenile myasthenia gravis. Objective The main objective of this study was to show that extended transsternal thymectomy is a valid option for treating this disease in paediatric patients. Results Twenty-three patients with juvenile myasthenia gravis underwent this surgical treatment in the period between April 2003 and April 2014; mean age was 12.13 years and the sample was predominantly female. The main indication for surgery, in 22 patients, was the generalised form of the disease (Osserman stage II) together with no response to 6 months of medical treatment. The histological diagnosis was thymic hyperplasia in 22 patients and thymoma in one patient. There were no deaths and no major complications in the postoperative period. After a mean follow-up period of 58.87 months, 22 patients are taking no medication or need less medication to manage myasthenic symptoms. Conclusions Extended (radical) transsternal thymectomy is a safe and effective surgical treatment for juvenile myasthenia gravis.