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REMOVAL OF THYMUS MAY HELP EASE MG SYMPTOMS

QUESTION: My son-in-law, 31, has MG. He was referred to specialists and had his thymus gland removed. Even though it was found of normal size, his eyesight improved and his weakness improved in a few months. Now, 16 months later, he is almost recovered. I hope you print this to help other patients. - R.D.

ANSWER: Thanks so much for the story and for giving me the opportunity to expand on the MG-thymus connection. Removal doesn't always work.There's much we don't know about myasthenia gravis, but the consensus is that it probably involves a misfiring of the body's immune system. The thymus (located below the neck) is part of that system. It programs certain white blood cells in their infection-fighting role.

The thymus enlarges up to puberty, then shrinks. By age 50, little of the gland remains, its duties taken over by other organs. Now some people develop a tumor of the thymus, and that may be involved in MG. In any event, removal of the gland often can bring it under control. And apparently, as in your son-in-law's experience, removal can help even when the gland tissue is found to be tumor-free.

To repeat, not everyone is a candidate for the removal and not every patient benefits from it. The idea should not create false hope.

For a discussion of the symptoms of the muscle-weakening illness and treatments, let me recommend to you an excellent source: The Myasthenia Gravis Foundation, 53 W. Jackson Blvd., Suite 1352, Chicago, IL 60604.

QUESTION: My husband developed some small tumors, which had to be removed. They were examined, and Weber-Christian disease was diagnosed from that. The doctor informed my husband that there isn't any cure for this. He is going to check him regularly for any new lumps. Can you tell us anything further about this disease? What is the outlook? - P.C.

ANSWER: Weber-Christian disease is one of those perplexing illnesses whose cause has yet to be found. Here, white blood cells somehow infiltrate fatty tissues, forming reddish skin nodules that are slightly tender. If only the surface fat is involved, the prognosis is quite good, and often there is a permanent remission of this mysterious process in a few years. For widespread involvement, cortisone drugs can be used for control.

QUESTION: Very recently, you mentioned a medicine for people with red noses. I realize you cannot answer individual letters, but would really appreciate your telling us again the name of that medicine. - J.J.

ANSWER: The condition was rosacea, and the medicine I mentioned was metronidazole, an ointment you apply to the affected skin. While I have your attention, I want to add that it is only one of many treatments for rosacea. Since that item appeared, readers have called my attention to old standbys, like tetracycline, and newer techniques, like laser treatment.

I should add a word about avoidance of anything that causes a blush, like alcohol, spices and caffeinated beverages. Blushing makes the rosacea worse.

QUESTION: What is hemolytic uremic syndrome? What causes it? How is it treated? It caused my husband's death. - Mrs. F.A.

ANSWER: In hemolytic uremic syndrome, red cells self-destruct (the hemolytic reference). Uremia refers to the fact that the kidneys fail with red cell breakup.

In children, the problem can sometimes follow a viral infection, such as stomach flu or a cold. Although they may have to weather a stormy course of illness, children usually emerge unscathed.

In adults, many times no such preceding infection can be found. And unfortunately in adults, the hemolytic uremic syndrome can be fatal.

Many treatments have been tried, but none has proven universally successful. The illness is one of those where our state of knowledge is simply inadequate. So sorry about your loss.