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Anesthetic management of patient with myasthenia gravis and uncontrolled hyperthyroidism for thymectomy


Department of Anesthesiology and Intensive Care and Cardiothoracic Surgery, G. B. Pant Hospital, New Delhi, India

Correspondence Address:
Vishnu Datt
Department of Anesthesiology and Intensive Care, G. B. Pant Hospital, New Delhi 110 002
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.58835

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Year : 2010  |  Volume : 13  |  Issue : 1  |  Page : 49-52

 

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The relationship between myasthenia gravis (MG) and other autoimmune disorders like hyperthyroidism is well known. It may manifest earlier, concurrently orafter the appearance of MG. The effect of treatment of hyperthyroidism on the control of MG is variable. There may be resolution or conversely, deterioration of the symptoms also. We present a patient who was diagnosed to be hyperthyroid two and half years before the appearance of myasthenic symptoms. Pharmacotherapy for three months neither improved the myasthenic symptoms nor the thyroid function tests. Thymectomy resulted in control of MG as well as hyperthyroidism. In conclusion, effective control of hyperthyroidism in the presence of MG may be difficult. The authors opine that careful peri-operative management of thymectomy is possible in a hyperthyroid state.






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Department of Anesthesiology and Intensive Care and Cardiothoracic Surgery, G. B. Pant Hospital, New Delhi, India

Correspondence Address:
Vishnu Datt
Department of Anesthesiology and Intensive Care, G. B. Pant Hospital, New Delhi 110 002
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.58835

Rights and Permissions

The relationship between myasthenia gravis (MG) and other autoimmune disorders like hyperthyroidism is well known. It may manifest earlier, concurrently orafter the appearance of MG. The effect of treatment of hyperthyroidism on the control of MG is variable. There may be resolution or conversely, deterioration of the symptoms also. We present a patient who was diagnosed to be hyperthyroid two and half years before the appearance of myasthenic symptoms. Pharmacotherapy for three months neither improved the myasthenic symptoms nor the thyroid function tests. Thymectomy resulted in control of MG as well as hyperthyroidism. In conclusion, effective control of hyperthyroidism in the presence of MG may be difficult. The authors opine that careful peri-operative management of thymectomy is possible in a hyperthyroid state.






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