A Follow-up for Myasthenia Gravis after Low Dose Whole Body Irradiation.
- Author:
Kyu Yong LEE
1
;
Young Joo LEE
;
Hee Tae KIM
;
Seung Hyun KIM
;
Ju Han KIM
;
Myung Ho KIM
Author Information
1. Department of Neurology, Collage of medicine, Hanyang University, Korea. kimmhl@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Whole body irradiation;
'Booster' whole body irradiation;
Myasthenia gravis;
Treatment method
- MeSH:
Follow-Up Studies*;
Humans;
Immunosuppression;
Lymphocytes;
Myasthenia Gravis*;
Whole-Body Irradiation*
- From:Journal of the Korean Neurological Association
2001;19(6):619-623
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Whole body irradiation (WBI) for myasthenia gravis is known to produce prolonged immunosuppres-sion with rare side effects. This study evaluated the duration of immunosuppression effects of WBI for long-term fol-low-up and decision time of 'booster' WBI treatments by analyzing clinical symptoms and laboratory findings. METHODS: We studied 11 patients with intractable myasthenia gravis. All patients had been treated with WBI and were followed for at least 5 years except for 2 patients died. Clinical status and immunological parameters were assessed at baseline and every year after the initial dose of irradiation. During the follow-up period, patients with declining clinical or immunological parameters were given 'booster' WBI treatments. RESULTS: WBI was associated with objective clini-cal improvements in seven patients: 3 patients had none or mild symptoms without any medications, 3 patients had 'booster' WBI treatments at 34 months(25-40 months) due to clinical or immunological declines, 1 patient had a stable clinical course with anticholinesterase medication. WBI was associated with clinical decline or no change in four patients: 2 patients died and 2 patients did not experience a change in clinical status. WBI produced a long-lasting lym-phopenia for more than 2 years with decreased absolute lymphocytes counts. There was no statistical differences in clinical and immunological parameters between the 'booster' WBI groups and non-'booster' WBI groups in good responders. 'Booster' WBI patients had no significant side effects. CONCLUSIONS: WBI has an effective therapeutic modality in intractable long-term myasthenia gravis. In this study, the duration of immnunosuppression effects of WBI was found to last 2 years. It is suggested that patients with declining clinical or immunological parameters be given 'booster' WBI treatments.
