Myasthenia gravis can be managed well with treatment. A treatment plan may involve one or more of the following:
Medications: Anticholinesterase medications like pyridostigmine and neostigmine control symptoms. Corticosteroids (e.g., prednisone) and immunosuppressants (e.g., azathioprine, cyclosporine, tacrolimus, mycophenolate mofetil, cyclophosphamide) can slow or stop the disease process. Although these medications don't cure it, they are the mainstay of long-term management.
Plasmapheresis: Large amounts of blood are removed, then put in a centrifuge to separate the red and white cells from the serum, the liquid that contains the immune antibodies which are doing the damage. The red and white cells are then replaced, along with donated or synthetic serum.
Immunoglobulin: The fact that this treatment works suggests that a weakened immune system is part of the cause of myasthenia gravis. Immunoglobulin therapy involves injections of blood serum from a person without autoimmune disease. It lowers the numbers of tissue-attacking antibodies in the bloodstream of the person with myasthenia gravis.
Thymectomy: The thymus isn't essential in adults and it can be surgically removed without negative effects. Symptoms will improve in about 70% of people who have a thymectomy, and some of these people may be cured. Many others can reduce the dose of their medication(s). In fact, the cure rate in myasthenia gravis patients with thymomas is about the same as in people with an apparently healthy thymus or a malfunctioning but non-cancerous thymus.
Some people diagnosed with myasthenia gravis are diagnosed with thymoma at the same time. Fortunately, thymomas are slow-growing tumours, and while they're not actually benign (noncancerous), they have a low chance of spreading in any given year. Most thymomas are found while they're still localized in the thymus, and removing that organ usually provides a complete and lasting cure for both the myasthenia and the cancer. In fact, myasthenia gravis is often a lifesaver, because it alerts doctors to a tumour while there's still plenty of time to do something about it.
Nothing can prevent this disease, since we don't know what causes it. However, serious complications can be prevented if people with myasthenia gravis go to the hospital if they ever have difficulty breathing. About 1 in 10 people with this disease will face a myasthenic crisis at some point.
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