Unilateral ptosis as an initial manifestation of D-penicillamine induced myasthenia gravis.

We describe 2 patients presenting with isolated unilateral ptosis without other signs of cranial or peripheral nerve involvement or sympathetic denervation. Both patients (one case of progressive systemic sclerosis and one of rheumatoid arthritis) were currently taking D-penicillamine. In these cases, the ptosis was reversed a few minutes after a Tensilon test, hallmark of myasthenia gravis.

Ten years experience with therapeutic apheresis in a community hospital.

A retrospective study was carried out on 2,500 therapeutic hemapheresis procedures performed at a community teaching hospital from 1980 to 1990. Seventy-six percent of the procedures consisted of plasmapheresis (PE). The most frequently treated conditions were myasthenia gravis (MG), Guillain-Barré syndrome (GB), hyperviscosity (HV), and thrombotic thrombocytopenia purpura (TTP).

Prognosis in occult thymomas in myasthenia gravis following transcervical thymectomy.

Thymomas were noted in 239 (11%) of 2097 myasthenic patients followed up at our institution. Among 996 patients who had undergone thymectomy, 191 patients (19%) had thymomas compared with 48 (4%) of 1101 patients treated without surgery. A definitive diagnosis of thymoma was not made until after thymectomy in 61 patients (35%); in patients not treated with thymectomy, 23% of associated tumors were diagnosed at autopsy.