Effective treatment of infantile myasthenia gravis by combined prednisone and thymectomy

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Abstract
Myasthenia gravis developed in 2 children at 2 and 3 yr of age. Minimal improvement followed chronic oral administration of cholinesterase inhibitors. The 1st patient had ptosis and ophthalmoplegia but no clinical or electromyographic involvement of muscles of the extremities, although a quadriceps muscle biopsy revealed lymphorrhages. The 2nd patient had progressive generalized myasthenia for 3.5 yr. Both children were given a 3 mo. course of prednisone followed by thymectomy. They both are in remission, 12 and 8 mo. after thymectomy, with only minimal residual ocular weakness, but this weakness is much more responsive to anticholinesterase drugs than before thymectomy. Long-term administration of steroids, with the attendant complication of growth retardation, is avoided.

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