title: Childhood onset myasthenia gravis.
abstract: The authors share experiences in taking care of 27 cases of childhood onset myasthenia gravis (MGS). In all cases, the diagnosis was confirmed by a combination of clinical examination and Neostigmine test. The majority (92%) had localized ocular myasthenia with median onset of symptoms at 33 months of age. About 24 per cent of them progressed to generalized MGS. A few (8%) presented with respiratory failure that required ventilatory support with onset of symptoms at about 22 months. Thymectomy was performed in 10 cases. Complete and partial remissions were achieved in about 70 per cent and 26 per cent of cases respectively with the combination of an immunosuppressant (azathioprine) and a Cholinesterase inhibitor (pyridostigmine). None experienced a myasthenic crisis with proper management and good follow-up using the above combinations.
authors.affiliation: Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Natte
authors.initials: N
authors.lastname: Raksadawan
authors.forename: Pongkiat
authors.initials: P
authors.lastname: Kankirawatana
authors.forename: Kampanad
authors.initials: K
authors.lastname: Balankura
authors.forename: Patcharin
authors.initials: P
authors.lastname: Prateepratana
authors.forename: Tumtip
authors.initials: T
authors.lastname: Sangruchi
authors.forename: La-Ongsri
authors.initials: LO
authors.lastname: Atchaneeyasakul
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D017668:Age of Onset; D001379:Azathioprine / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009157:Myasthenia Gravis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D013256:Steroids / Q000008:administration & dosage; D013785:Thailand / Q000453:epidemiology; D013934:Thymectomy / Q000379:methods; D016896:Treatment Outcome
chemical_list: D013256:Steroids; D001379:Azathioprine