Abstract

MAINIERI HIDALGO, José A  and  LEPIZ CORDERO, lvannia. Timectomía por miastenia gravis en el Hospital Dr. Rafael Angel Calderón Guardia: Reporte de 24 casos. Acta méd. costarric [online]. 2000, vol.42, n.2, pp.81-85. ISSN 0001-6002.

Background: Miastenia gravis is an autoimmune disease, its etiology has not been defined clearly. The improvement of  the clinical manifestations after thymectomy was first describes in 1912; and this procedure has become in one of the therapeutic alternativas for the disease nowadays. The aim of the present study was to investigase the results of thymectomy for miastenia gravis in the Hospital Dr. R. A. Calderón Guardia. Materials and Methods: Retrospective study, based in the revision of the clinical files of 24 consecutive patients in whom a thymectomy was performed as part of their treatment for miastenia gravis between January 1992 and May 1999 in the Hospital Dr. R. A. Calderon Guardia. Results: 75% of the patients improved their condition after the surgery, 17% had no variation and 8% deteriorated their clinical condition after the thymectomy. There was no difference in the clinical outcome relates to sex, age or presence of thymoma. However, patients that only had ocular manifestations previous to the surgery had a tendency to remain symptomatic after surgery. The pre-surgical preparation of the palien with intravenous gamma globulin and the improvements in the anesthetic technique lowered the need for mechanical ventilation. Conclusion: Thymectomy improved 75% of the patients with miastenia gravis, specially those who had other manifestations apart from ocular involvement. The procedure allowed the reduction of treatment in 12 of the 24 cases studied.

Keywords : Timectomía; Myasthenia Gravis.