Effect of Thymectomy on Drug Requirement of Myasthenia Gravis Patients

Abstract

Objective: To determine the effect of thymectomy on the drug requirement of myasthenia gravis.
Methods: Forty patients of myasthenia gravis admitted in Neurology Department Mayo Hospital
Lahore were registered. After recording their demographic profile and confirmation of their
diagnosis of myasthenia gravis, they were subjected to thymectomy. Their dosages of drugs
before thymectomy were recorded and were compared with dosage requirements at 18-30
months post thymectomy.
Results: Thymectomy was done in 34 out of 40 patients. Five patients out of total 40 lost follow
up and one was referred to oncology. 34 patients remained for follow up, 30 thymectomized and 4
nonthymectomized. The results indicate a marked reduction in average doses of pyridostigmine
(90mg vs 270mg; p<0.001), steroids (7.5mg vs 38mg) and azathioprine (100mg vs 118mg) at 18-
30 months after thymectomy as compared to before thymectomy. At 18-30 months of follow up,
thymectomized patients were using considerably lesser dosages of pyridostigmine (90mg vs
200mg), steroids (7.5mg vs 30mg) and azathioprine (100mg vs 125mg) as compared to non
thymectomized patients.
Conclusion: The intra-articular NSAIDs injection is a more effective treatment option compared
to intra-articular steroid injection for the management of adhesive capsulitis of the shoulder.