Résumé
Graves disease occur in association with myasthenia gravis is rare. We report a case of Graves disease and myasthenia gravis treated by bilateral subtotal thyroidectomy and total thymectomy simultaneously. A 37 year old woman was admitted with anterior neck mass and ptosis. Various examinations were compatible with combined Graves disease and myasthenia gravis. The bilateral subtotal thyroidectomy and total thymectomy were done simultaneously. The pathologic diagnosis was Graves disease and thymic hyperplasia. The patients postoperative course was uneventful. The thyroid function of patient became euthyroid and the clinical symptoms related with myastenia gravis resolved during follow up period.
Sujets)
Adulte , Femelle , Humains , Diagnostic , Études de suivi , Maladie de Basedow , Myasthénie , Cou , Thymectomie , Hyperplasie du thymus , Glande thyroide , ThyroïdectomieRésumé
Objective To evaluate the effect of medicial and surgical treatment for juvenile hyperthyroidism.Methods Ortapazole was administ rated separately in drug therapy group for 1.5-2 years.Bilateral subtotal thyroidectomy was done in surgical therapy group.Results In drug therapy group,effective rate was 60 percent in 6 months and 70 percent in one year.Recurrence rate was 40 percent after drug withdrawal in 2 years curative rate was 60 percent.In surgical therapy group,the average stay in hospital was 16 days.There was no nerve injury,parathyroidal hypofunction,thyroid crisis or hypothyroidism complications,with 100 percent curative rate after 2 years′ followup.Postoperative growth and development were normal.Conclusions Surgical treatment may be suitable for those who have no response to drug therapy,with recurrence after drug withdrawal,whose compression symptom was obvious,with moderate and severe hyperthyroidism or those who could not take medicine persistently.Bilateral subtotal thyroidectomy applied in juvenile hyperthyroidism could achieve quick and better recovery,and has no influence on the juvenile growth and development.