Thymectomy in black children with juvenile myasthenia gravis.
Fifteen black children with juvenile myasthenia gravis presented to our institution over a 10-year period at ages ranging from 18 months to 7 years, 4 males and 11 females. Twelve presented with progressive, generalised weakness and 3 had bulbar manifestations. Ocular signs were absent in 2 patients. All 15 patients were placed on pyridostigmine bromide (Mestinon) and 1 also required steroids and plasmapheresis. Medical therapy only was instituted in 5 patients, of whom 2 came to surgery, 2 died, and 1 was lost to follow-up. Thymectomy was performed in 12 children (including the 2 with failed medical therapy) via a median sternotomy with no mortality or morbidity related to the operation. The timing of surgery was less than 3 months in 75% of the children. Thymic hyperplasia was noted in 10 glands and 2 were reported as normal. Of the children in the operative group, 83% are on minimal medication or in total remission. Better results were noted in young patients with early thymectomy and diseased glands.
Lakhoo
K
K
Department of Paediatric Surgery, Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa.
Fonseca
J D
JD
Rodda
J
J
Davies
M R
MR
D044383:Black People; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009157:Myasthenia Gravis / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D009460:Neurologic Examination; D013934:Thymectomy; D013950:Thymus Gland / Q000473:pathology; D013952:Thymus Hyperplasia / Q000175:diagnosis / Q000473:pathology / Q000601:surgery