Role of preoperative immunosuppressant therapy in prevention of pot-thymectomy myasthenic crisis

Background: myasthenia gravis is an autoimmune disease characterized by varying degrees of skeletal muscle weakness which worsens with exertion. aim: to observe the incidence of myasthenic crisis in patients with myasthenia gravis with induction of complete remission via immunosuppressant therapy in the postthymectomy phase. methodology: this was a prospective interventional study. this study was undertaken at the department of thoracic surgery,king edward medical university/mayo hospital lahore between june 2009 and may 2017. results: 132 patients,83 females and 49 males in complete remission were thymectomized via trans-sternal approach. all these patients were observed for precipitation of myasthenic crisis in the post-operative phase. none of the patients had any clinical evidence suggesting myasthenic crisis or worsening of myasthenic symptoms in the early or intermediate post-operative phase. conclusion: it is hereby concluded that immunosuppressant therapy and induction of complete remission of myasthenia gravis ensures the prevention of myasthenic crisis in post-thymectomy patients,which if precipitated can have significant morbidity and mortality in such patients.