title: Anesthetic management of patient with myasthenia gravis and uncontrolled hyperthyroidism for thymectomy.
abstract: The relationship between myasthenia gravis (MG) and other autoimmune disorders like hyperthyroidism is well known. It may manifest earlier, concurrently or after the appearance of MG. The effect of treatment of hyperthyroidism on the control of MG is variable. There may be resolution or conversely, deterioration of the symptoms also. We present a patient who was diagnosed to be hyperthyroid two and half years before the appearance of myasthenic symptoms. Pharmacotherapy for three months neither improved the myasthenic symptoms nor the thyroid function tests. Thymectomy resulted in control of MG as well as hyperthyroidism. In conclusion, effective control of hyperthyroidism in the presence of MG may be difficult. The authors opine that careful peri-operative management of thymectomy is possible in a hyperthyroid state.
authors.affiliation: Department of Anesthesiology and Intensive Care and Cardiothoracic Surgery, G. B. Pant Hospital, New Delhi, India. dattvishnu@yahoo.com
authors.forename: Vishnu
authors.initials: V
authors.lastname: Datt
authors.forename: Deepak K
authors.initials: DK
authors.lastname: Tempe
authors.forename: Baljit
authors.initials: B
authors.lastname: Singh
authors.forename: Akhlesh S
authors.initials: AS
authors.lastname: Tomar
authors.forename: Amit
authors.initials: A
authors.lastname: Banerjee
authors.forename: Devesh
authors.initials: D
authors.lastname: Dutta
authors.forename: Hricha
authors.initials: H
authors.lastname: Bhandari
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000379:methods*; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications / Q000601:surgery*; D008297:Male; D009157:Myasthenia Gravis / Q000150:complications / Q000601:surgery*; D013934:Thymectomy