泼尼松龙
医学
血浆置换术
重症肌无力
甲基强的松龙
外科
胃肠病学
内科学
免疫学
抗体
作者
Yuriko Nagane,Shigeaki Suzuki,Norihiro Suzuki,Kimiaki Utsugisawa
出处
期刊:European Neurology
[S. Karger AG]
日期:2010-11-30
卷期号:65 (1): 16-22
被引量:44
摘要
<i>Background/Aims:</i> In treating myasthenia gravis (MG), our aims were to achieve early minimal manifestations (MM) by performing early aggressive therapy (EAT) using plasmapheresis and high-dose intravenous methylprednisolone, and then to maintain the status with low-dose oral corticosteroids (EAT strategy). We examined the merits of the EAT strategy. <i>Methods:</i> We retrospectively analyzed long-term effects of the EAT strategy (duration of therapy: 4.1 years) for 49 de novo MG patients and compared the effects to those of high-dose oral prednisolone therapy for 22 patients. <i>Results:</i> The EAT group achieved marked early improve- ment with much lower doses of oral prednisolone compared to the high-dose prednisolone group. The patients who achieved MM with prednisolone ≤5 mg/day were more frequent in the EAT group at both 1 year (57.1 vs. 4.5%) and final observation (77.6 vs. 27.3%). Both new-onset diabetes and patients who had complained of moon face were less frequent in the EAT group. However, in the EAT group, due to a temporary inability to maintain MM, additional short-term hospitalizations to return to MM by EAT were required. <i>Conclusions:</i> The EAT strategy has advantages of early improvement with less frequent steroid-related complications. The labor and cost required are evident disadvantages.
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