BRAIN and NERVE－神経研究の進歩63巻7号

2011年07月発行

増大特集 神経筋接合部―基礎から臨床まで

重症筋無力症治療の現状と展望―胸腺手術の観点から

著者： 吉川弘明¹ 岩佐和夫² 高守正治³

所属機関： ¹金沢大学保健管理センター ²金沢大学大学院医学系研究科　脳老化・神経病態学（神経内科） ³金沢西病院脳神経センター

ページ範囲：P.729 - P.736

文献概要

はじめに

　重症筋無力症（myasthenia gravis：MG）の臨床における現状は，大きく変化している^1）。その理由として，①アセチルコリン受容体抗体（acetylcholine receptor antibody：AChR Ab）の測定が容易となり，診断が早期にされるとともに診断の正確さが向上した，②ステロイドによる治療が浸透するとともに，その使用方法が改善された，③免疫抑制薬（わが国においては，特にカルシニューリン阻害薬）の併用療法が広がった^2），④胸腺摘除術適応の見直しが進んでいる，⑤MG患者の年齢分布が変化している，といった原因が挙げられる。これら5つの原因はそれぞれが独立しているようで互いに関連している。本稿では，神経内科医の立場からMG治療の現状と展望について，特に胸腺手術に重点を置いてまとめてみたい。

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