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Volume 6
Journal of Child and Adolescent Behavior
October 01-02, 2018 Osaka, Japan
3
rd
World Congress on
Pediatric Neurology and Pediatric Surgery
Neuropediatrics 2018
October 01-02, 2018
Thymectomy role in juvenile myasthenia gravis: A longitudinal case
Junita Elvira, Dwi P Widodo and Hardiono D Puspnegor
University of Indonesia, Indonesia
Y
asthenia Gravis (MG) is an immune-mediated Neuro-Muscular Junction (NMJ) dysfunction characterized by weakness
and fatigability of ocular, bulbar and extremity striated muscle. The world prevalence was 125/1,000,000 and up to 50%
in Asian population the first manifestation present at childhood. Some cases of pre-pubertal juvenile MG (JMG) that only
presented by ocular symptom was spontaneous remission, in other hand some cases were developed into general MG. Aim
of the study is to demonstrate a first case of JMG patient that was underwent thymectomy at Cipto Mangunkusumo Hospital
(CMH). 2 years 3 months old boy with JMG was referred to CMH because of minimal improvement with optimal dose of
Pyridostigmine and steroid. The first symptom was only left ocular sign and became worsening to general in less than 1 year.
Acetylcholine esterase receptors (AChRs) binding and blocking autoantibodies were both increased and the imaging revealed
of homogenous solid mass with relatively firm limits. Pathology examination showed hyperplastic thymus with thymus cyst.
After thymectomy the clinical manifestations seem to be well improved but there was some episode of relapsed for about 2 years
and the patient became steroid dependent. In the last 6 month, a very slow steroid tapering off was succeeded and remission
occurred. Although there is a possibility for remission, early thymectomy may be considered for certain cases of JMG.
junita.elvira2014@gmail.comJ Child Adolesc Behav 2018, Volume 6
DOI: 10.4172/2375-4494-C1-006