Complicating autoimmune diseases in myasthenia gravis: a review

Abstract

Myasthenia gravis (MG) is a rare autoimmune disease of skeletal muscle endplates. MG subgroup is relevant for comorbidity, but usually not accounted for. MG patients have an increased risk for complicating autoimmune diseases, most commonly autoimmune thyroid disease, systemic lupus erythematosus and rheumatoid arthritis. In this review, we present concomitant autoimmune disorders associated with the different MG subgroups, and show how this influences treatment and prognosis. Concomitant MG should always be considered in patients with an autoimmune disorder and developing new neuromuscular weakness, fatigue or respiratory failure. When a second autoimmune disorder is suspected, MG should be included as a differential diagnosis.

Gender and quality of life in myasthenia gravis patients from the myasthenia gravis foundation of America registry

“…Thymectomy is associated with improved QOL in women, effectively eliminating the gender gap with men, regardless of whether the men had or had not undergone thymectomy. Autoimmune and treatment related comorbidities were commonly reported in this population, consistent with previous reports …”

“…For example, systemic lupus erythematosus was reported in 1.8% of our study population, while the prevalence in general population is less than 0.1% . A greater prevalence of other autoimmune diseases among MG has been well described . Autoimmune thyroid disease, systemic lupus erythematosus, and inflammatory bowel disease were more common in women, whereas type 1 diabetes mellitus and psoriasis were not, which is also consistent with the literature …”

B cells in the pathophysiology of myasthenia gravis

“…EOMG is often characterized by thymic hyperplasia, whereas cases of LOMG have thymic abnormalities less frequently. Concomitant autoimmune diseases in patients with AChR MG are not uncommon, being reported in 13%–22% of patients . The most frequently associated autoimmune disease is thyroid disease, followed by systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).…”

A 49-Year-Old Man with Combined Myasthenia Gravis, Autoimmune Thyroiditis and IgG4 Orbitopathy

“…One theory is the genetic influence. Early onset MG (<50-year-old) and other autoimmune disorders are associated with the HLA A1-B8-DR3-DQ2 haplotype [8]. An association between the multiple sclerosisassociated allele DRB1*15:01 and the late-onset MG (>50-yearold) has been reported [9].…”