A New Approach to the Treatment of Myasthenia Gravis : Continuous Administration of Small Doses of Prednisolone
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概要
- 論文の詳細を見る
Myasthenia gravis is considered as an auto-immune disease, but the effectiveness of corticosteroids in the treatment of this disease has not generally been recognized. Recently, short and intensive courses of ACTH or corticosteroids have been indicated to be effective in the management of severe, generalized myasthenia gravis. However, such treatment should be undertaken in an intensive care unit because of the exacerbation of muscle weakness, and care has to be taken against the hazardous side effects of corticosteroids. Continuous treatment with small doses of prednisolone, 5 to 10 mg daily, was evaluated in the present study. Eight thymectomized and eight non-thymectomized patients with myasthenia gravis were administered prednisolone continuously for 2 to 32 months. About 70% of the patients improved markedly, and 20% remitted, regardless of thymectomy. The improvement of myasthenic symptoms occurred gradually for 2 to 3 months after the onset of this treatment. Since a few patients tended to be in cholinergic and unstable conditions, the dosage of A-Ch-E drugs had to be decreased very gradually to prevent a cholinergic crisis before improvement occurred. Marked improvements or remissions were recognized for 3 to 5 months after the beginning of this treatment. From these results, it was concluded that continuous treatment with small doses of prednisolone might be effective in the management of generalized myasthenia gravis regardless of thymectomy and the severity of the disease with few limitations on the indication. The mechanisms of action of prednisolone may be normalization of thymic and lymphocytic functions, and blocking of antibody binding to acetylcholine receptors.
- 東海大学の論文
著者
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ARIMORI Shigeru
Department of Internal Medicine, School of Medicine, Tokai University
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ICHIKAWA Yukinobu
Department of Internal Medicine, Tokai University School of Medicine
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Ichikawa Yukinobu
Department Of Internal Medicine 4 Tokai University School Of Medicine
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Ichikawa Yukinobu
Department Of Internal Medicine School Of Medicine Tokai University
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Arimori Shigeru
Department Of Intenal Medicine School Of Medicine Tokai University
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