Development of myasthenia gravis (MG) after splenectomy

196 DEVELOPMENT OF MYASTHENIA ORAVIS (MG) A F r E R S P L ~ C T O M Y Haddad, MS; Baeta, AM; Tinone, G; Assis, J L ; Marchiori FE; Scarf, M. -Department of Neurology, S~o l'aulo University, School of Medicine - S~o Paulo BRASIL Splenectomy as a therapeutic resort to patients with MG severe and unresponsive to other treatment modalities has been done in some cases. This proc.edure was proposed due to immunepathogenic aspects of MG. JF, a 47 years old white male, underwent to examination in our hospital, reporting traumatic rupture of the spleen and splenectomy when was 42 yeaxs-old. He evolved with general muscle weakness and MG was diagnosed. Laboratory findings included little thymes in thoracic computerized tomography and determination of acetylcholine receptor antibodies sbowe~ a le,'~l of 42 n mol/l. The patient received pyridestigr, dne (180mg/daily) with great reduction of symptons. After 5 years, he ese~ only 30 mg ,~f pyridostigmine/daily and persists with discret tetraparesia and facial diparesia. A patient who developed MG after splenectomy corroborates the impression that the physiopathogenic basis to justify that procedure is not cunvincent.

MYASTI-mNIA GRAVIS AND PSORIASIS - A CASE I ~ P O R T Tinone, G; Haddad, MS; Ba~ta, AM: Marchiori, PE: Assis, J L ; Scaff~ M Department of Neurology of Silo Paulo School of Medicine. Silo Paulo - Brazil Myasthenia gravis (MG) is an autoimmune disease frequently associated with other iml~unological diseases. Association with peoriasis, however is rare. We report a 34 years old psoriatic patient who developed a severe generalized adult-type MG. She received anticholinesterase agents (pyridostigmine IR0 mg daily) and prednisune 60 mg daily with initial improvement of both the myasthenic symptoms and the psoriatic rash. Thoracic CT scan was normal. Subsequently however she showed progressively deterioration of her condition in spite of medical treatment and a thymectomy was performed. Post-operative medications, included: Metrothexate, pyHdostigmine and decreasing doses of pr~Jaisone. Thymectomy improved myasthenic symptoms but did not the course Of the psoria,~is.