Currently, there are scarce data on how COVID-19 affects people with myasthenia gravis. Theoretically, there is a higher risk of experiencing severe manifestations of COVID-19 due to the common use of immunosuppressive drugs and potential respiratory failure in relation to respiratory muscle weakness. This is one of the early cases of COVID-19 reported in association with myasthenia gravis. Here, we highlight the prognosis, discuss the pathophysiological mechanisms, and prompt the consideration of convalescent plasma therapy in myasthenia gravis patients with concomitant COVID-19.

features of IPEH on histopathology include papillary structures and hyperplastic endothelial cells contained within the vascular lumen. It has been described in association with a wide range of lesions such as cavernous hemangiomas, varices, and lymphangiomas. Intravascular papillary endothelial hyperplasia can mimic angiosarcoma, a highly malignant tumor capable of metastasis. The distinction can be made on histopathology, with angiosarcomas showing tissue invasion beyond blood vessels and exhibiting malignant cytologic features. 2 The first orbital case of IPEH was reported by Weber and Babel in 1981. 6 Since then, our literature review revealed a total of 24 cases in periocular soft tissues. 7-13 Among these, only 11 were located deep within the orbit and 3 of those were reported during the past year. 8,11,12 The onset of proptosis can be acute or gradual. 4 The process is most often painless, but acute presentations may be associated with some degree of discomfort. 12,13 Orbital IPEH will often distort surrounding structures and may cause a significant mass effect in some cases. Bone erosion is rare but has been described in the original case reported by Weber et al. 6 Compression of the supraorbital nerve has been reported in 1 case and resulted in persistent numbness despite surgical removal of the mass. 7 Only 2 cases presented as ours, with a significant decrease in vision (counting fingers) from compressive optic neuropathy. 9,11 Unfortunately, these patients did not recover vision postoperatively. Two other cases were associated with optic nerve edema, but without any impact on vision. 4,6 Intravascular papillary endothelial hyperplasia should be included in the differential diagnosis of any orbital lesion associated with compressive optic neuropathy. Surgical excision is required to confirm diagnosis and remains the mainstay of treatment. Our case is the first to highlight that complete surgical excision can lead to significant visual recovery in patients with compressive optic neuropathy.

Scimitar syndrome is a very rare disorder and also known as hypogenetic lung syndrome. The syndrome is characterized with anomalous connection of the pulmonary vein with the vena cava inferior. In this text, scimitar syndrome associated with pulmonary artery hypoplasia is presented. A 21-year-old male patient with complaints of cough, shortness of breath and sputum was admitted. Chest X-ray revealed volume loss of right lung and shift to the right of heart and mediastinum. The middle lobe wasn’t observed in bronchoscopy and thorax CT. Thoracic CT angi-ography images revealed that vein of right lung lower lobe drains right hepatic vein and right pulmonary artery diameter is reduced. Lung perfusion scintigraphy revealed total loss of perfusion of right lung. Scimitar sign on chest X ray is characteristics for scimitar syndrome. However, this sign cannot be seen in some patients. If there is volume loss of right lung and shift to the right of heart and mediastinum, scimitar syndrome should be considered in addition to other diseases