title: Preoperative high-dose steroid has long-term beneficial effects for myasthenia gravis.
abstract: Previous studies addressing preoperative steroid treatment have revealed that control of myasthenia gravis (MG) with steroids prior to surgery appeared to stabilize postoperative status. The purpose of our study was to clarify the clinical benefits of the preoperative programmed high-dose steroid treatment on the long-term outcomes of MG patients. We retrospectively reviewed the records of 171 MG patients who were followed up after undergoing thymectomy in our hospital between 1988 and 2006. One hundred and thirteen patients in the programmed treatment group had received preoperative steroid treatment, while 58 patients received no steroid treatment during the preoperative period. Clinical remission, which was defined as the achievement of the modified pharmacologic remission (PR) for at least 1 year, and clinical benefits were compared between the two groups. With regard to the remission after thymectomy, Kaplan-Meier life-table curves for patients in the preoperative steroid treatment group versus those for patients in the no steroid preoperative treatment group revealed a significantly higher probability of the PR in the preoperative steroid treatment group (log-rank test, P < 0.01). This study might be the first, as per our knowledge, to indicate that preoperative programmed high-dose steroid treatment has long-term beneficial effects for MG patients.
authors: Division of Neurology, Department of Internal Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
authors: Syuichi
authors: S
authors: Tetsuka
authors: Ken-Ichi
authors: K
authors: Fujimoto
authors: Kunihiko
authors: K
authors: Ikeguchi
references: Nat Clin Pract Neurol. 2008 Jun;4(6):317-27
references: 18493241
references: Neurology. 2003 Dec 23;61(12):1652-61
references: 14694025
references: Eur J Cardiothorac Surg. 2010 May;37(5):1137-43
references: 20117014
references: Interact Cardiovasc Thorac Surg. 2006 Feb;5(1):42-6
references: 17670509
references: Ann Thorac Surg. 2004 May;77(5):1745-50
references: 15111178
references: J Neurol Sci. 1991 Dec;106(2):213-20
references: 1802969
references: Muscle Nerve. 2010 Jul;42(1):5-13
references: 20583125
references: N Engl J Med. 1974 Jan 10;290(2):81-4
references: 4808454
references: Jpn J Surg. 1987 Jan;17(1):14-20
references: 3573441
references: Autoimmunity. 2010 Aug;43(5-6):428-35
references: 20166870
references: Ann Neurol. 1995 May;37 Suppl 1:S51-62
references: 8968217
references: Infect Immun. 1982 Oct;38(1):122-6
references: 6754609
references: Proc Natl Acad Sci U S A. 1992 Nov 1;89(21):9991-5
references: 1279685
references: Eur J Cardiothorac Surg. 2006 Sep;30(3):525-8
references: 16857374
references: Eur J Cardiothorac Surg. 1989;3(6):504-9; discussion 510-1
references: 2635936
references: Neurology. 2000 Aug 8;55(3):448-50
references: 10932288
references: Ann N Y Acad Sci. 2003 Sep;998:413-23
references: 14592909
references: Gen Thorac Cardiovasc Surg. 2008 Mar;56(3):114-8
references: 18340510
references: Arch Neurol. 1985 Dec;42(12):1149-53
references: 4062612
references: Eur J Cardiothorac Surg. 2004 Aug;26(2):407-11
references: 15296906
references: Cochrane Database Syst Rev. 2005 Apr 18;(2):CD002828
references: 15846640
references: Eur Neurol. 2005;53(3):146-50
references: 15900097
references: Eur J Neurol. 2010 Jul;17(7):913-21
references: 20402761
references: J Neurol. 1997 Sep;244(9):542-7
references: 9352450
references: Muscle Nerve. 2003 Nov;28(5):570-4
references: 14571458
references: Eur J Cardiothorac Surg. 2006 Jun;29(6):908-13
references: 16675232