Intractable Myasthenia Gravis Accompanied with Thymoma;Report of a Case

A 46-year-old female visited a hospital due to pelvic inflammatory disease (PID) and then her chest computed tomography revealed an abnormal shadow in the upper mediastinum. Four months later,she complained muscle weakness with her limbs, dysphagia, and ptosis of her eyelids. Total thymectomy was pe...

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Published inKyobu geka. The Japanese journal of thoracic surgery Vol. 69; no. 10; p. 881
Main Authors Naomi, Akira, Oyamatsu, Yoshinori, Narita, Kunio, Nakayama, Masato, Maeda, Shoki
Format Journal Article
LanguageJapanese
Published Japan 01.09.2016
Subjects
Female
Humans
Middle Aged
Myasthenia Gravis - complications
Myasthenia Gravis - diagnostic imaging
Thymoma - complications
Thymoma - diagnostic imaging
Thymoma - surgery
Thymus Neoplasms - complications
Thymus Neoplasms - diagnostic imaging
Thymus Neoplasms - surgery
Tomography, X-Ray Computed
Treatment Outcome
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Summary:A 46-year-old female visited a hospital due to pelvic inflammatory disease (PID) and then her chest computed tomography revealed an abnormal shadow in the upper mediastinum. Four months later,she complained muscle weakness with her limbs, dysphagia, and ptosis of her eyelids. Total thymectomy was performed through a median sternotomy for mass lesion, which was pathologically proven to be type B1 thymoma. Postoperative myasthenia gravis (MG) crisis, which led to respiratory failure requiring intubation and mechanical ventilation, developed and laboratory tests showed elevated serum anti-AChR Ab(130 nmol/l), antinuclear antibody( ×640 serum dilution, speckled pattern) and anti-RNP Ab(129.2 U/ml). For MG crisis, steroid pulse therapy, immunosuppressive therapy and immuno absorption were performed, and she successfully weaned from mechanical ventilaton on 41 post operative day (POD). Some factors such as inapparent mixed connective tissue disease (MCTD) and Anti RNP antibody were thought to be a cause for having any difficulty in MG treatment in the present case.
ISSN:0021-5252