High Prevalence of Systemic Lupus Erythematosus in 78 Myasthenia Gravis Patients: A Clinical and Serologic Study

Sthoeger, Zev; Neiman, A; Elbirt, Daniel; Magen, Eli; Burstein, R; Eitan, S; Zinger, Hiedy; Mozes, Edna; Abarbanel, J. M.

doi:10.1097/00000441-200601000-00004

Cited by 49 publications

(46 citation statements)

References 17 publications

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“…Među pacijentima obuhvaćenim našom studijom, autoimune bolesti koje su se najčešće javljale udružene sa MG bile su Hašimoto tireoiditis, SLE, polimiozitis, RA i perniciozna anemija, što je u skladu sa nalazima drugih studija (9,15,23,25,26). Učestalost Hašimoto tireoiditisa iznosila je 4%, a skoro isti podatak (4,2%), dobijen je u studiji sprovedenoj u Japanu na 142 pacijenta sa MG (24).…”

Section: Diskusijaunclassified

“…Učestalost Hašimoto tireoiditisa iznosila je 4%, a skoro isti podatak (4,2%), dobijen je u studiji sprovedenoj u Japanu na 142 pacijenta sa MG (24). Zapažene učestalosti SLE u literaturi variraju od 1 do 8%, što je u skladu sa našim rezultatom od 1,3%, dok je učestalost udruženog javljanja RA u našoj studiji bila manja u odnosu na podatke iz drugih studija (0,9% naspram 4%) (9,15,23,25,26). Suzuki i saradnici (27) zabeležili su učestalost polimiozitisa od 0,65%, što je približno vrednosti od 0,9%, dobijenoj u našoj studiji.…”

Section: Diskusijaunclassified

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Frequency of familial occurrence and associated autoimmune diseases in a cohort of patients with acquired autoimmune myasthenia gravis from Belgrade

Josipovic¹,

Jovanović²,

Jadžić³

et al. 2017

Med podmladak

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Introduction: Myasthenia gravis (MG) can be associated with other autoimmune diseases (AID), most frequently with Hashimoto's thyroiditis, systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Familial occurrence (FOMG) is rare and it exists in 3.5-4.2% patients with MG. Aim: To determine the occurrence of FOMG, the occurrence of AID associated with MG and to identify potential risk factors for developing MG in a cohort of patients from Belgrade. Material and Methods: This study gathered data from 453 patient histories from the period from1992-2014, from the Clinic of Neurology, Clinical Center of Serbia. Three analyses were performed. The first one measured the frequency of associated AID in patients with MG. In the second one, patients who had MG associated with AID were compared to patients without associated AID. The third one included patients with FOMG and compared them with patients without FOMG. The demographic and clinical characteristics of these patients were analysed and comparisons were made between observed and control groups. Results: The associated AID were present in 54 (11.9%) patients, the most frequent was Hashimoto thyreoiditis (4%), then SLE (1.3%), and RA, polymyositis and pernicious anaemia (0.9%). Patients with co-occurrence of MG and other AID were, in comparison with control group, more often female, and the difference was on the border of statistical significance (p=0.056). They had late onset MG (LOMG) more frequently, a mild form of MG and positive anti-AChR antibodies, but these differences weren't statistically significant. FOMG was seen in 2.2% of patients. They had LOMG more frequently, were predominantly men, seropositive, and with mild form of the disease, but with no statistical significance compared to the control group. Conclusion: In the Belgrade cohort, MG was often associated with other AID, while FOMG was relatively rare. There was no significant difference, statistically, in the observed clinical and demographic characteristics of analysed groups, compared to control groups.

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Section: Diskusijaunclassified

Frequency of familial occurrence and associated autoimmune diseases in a cohort of patients with acquired autoimmune myasthenia gravis from Belgrade

Josipovic¹,

Jovanović²,

Jadžić³

et al. 2017

Med podmladak

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“…Antinuclear antibodies (ANAs) occur more frequently in patients with MS or MG than in the general population, and their presence often causes uncertainty in the diagnosis of these two diseases [10][11][12] . ANAs usually occur in 20 to 30% of MS patients and can be observed in almost 40% of MG patients [11][12][13] .…”

Section: Casementioning

confidence: 99%

“…ANAs usually occur in 20 to 30% of MS patients and can be observed in almost 40% of MG patients [11][12][13] . The high frequency of ANAs in MS and MG probably reflects ongoing systemic immune dysregulation [11][12][13] .…”

Section: Casementioning

confidence: 99%

Myasthenia gravis and multiple sclerosis: an uncommon presentation

Lorenzoni

Scola

Kay

et al. 2008

Arq. Neuro-Psiquiatr.

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Myasthenia gravis (MG) is an autoimmune disease that compromises neuromuscular transmission and is mediated by autoantibodies against acetylcholine receptors on the postsynaptic membrane 1 . In its usual form it leads to symptoms of decreased muscle strength and fatigue 1 . Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the central nervous system that shows a wide range of clinical features and a variable natural history 2 . There is some evidence that patients with MG or MS have a higher risk of developing autoantibodies and other neuroimmune disorders than normal controls 3,4 . An autoimmune pathogenesis is implicated in both MG and MS, but the coexistence of the two disorders has rarely been documented, and for this reason we report this case 4 . CASEA 28-year-old woman presented with diplopia, dysphagia and mild limitation of ocular movements, with progressive palpebral ptosis and weakness, which changed in intensity from day to day and during the day according to the patient's physical activity.Physical examination did not reveal any abnormalities. On neurological examination she was found to have asymmetrical palpebral ptosis (left>right); symmetrical muscle weakness (grade 4 on the MRC scale) in the proximal upper and lower limbs; and deep tendon reflexes. Gait and all sensory examinations were normal.The investigation yielded the following results: (1) positive anti-acetylcholine receptor antibody test (14.91 nmol/L; normal < 0.20 nmol/L); (2) normal needle electromyography and nerve conduction studies; (3) repetitive stimulation of the facial, spinal accessory and ulnar nerves at 3 Hz with a decrement of more than 10% in compound muscle action potential amplitude (Fig 1); and (4) improvement of symptoms after treatment with pyridostigmine (180 mg daily). Chest computed tomography scan was normal.A diagnosis of MG was made, and the patient showed an improvement in symptoms after she started to receive prednisone and pyridostigmine. Prednisone was discontinued after one year and was followed by oral administration of azathioprine (100 mg/day), with an improvement in palpebral ptosis and muscle strength (grade 5 on the MRC scale).When she was 32 years old and still on azathioprine treatment, the patient developed a sudden weakness in her left lower limb and was treated with prednisone (60 mg/day). After this new neurological manifestation suggestive of MS, the patient was submitted to brain magnetic resonance imaging (MRI), which revealed multiple areas of high signal on FLAIR and T2-weighted images in the periventricular and subcortical white matter of the brain hemispheres (Fig 2A).

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“…5,8 This statistics may be higher, because the use of immunosuppressants in the treatment of MG may mask SLE development. 3,9 This study aimed at reporting one case of MG in a patient previously diagnosed with SLE according to the American College of Rheumatology criteria.…”

Section: Introductionmentioning

confidence: 99%

Lúpus Eritematoso Sistêmico com fraqueza muscular por Miastenia Gravis

Studart¹,

Rodrigues²,

Soares³

et al. 2011

Rev. Bras. Reumatol.

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Systemic lupus erythematosus (SLE) and myasthenia gravis (MG) are autoimmune diseases, whose association in the same patient is rarely reported. Both pathologies share the following characteristics: affect mainly young women; alternate exacerbation and remission periods; and have positive antinuclear antibody (ANA) test. This case report assesses possible diagnostic hypotheses for the clinical fi ndings of eyelid ptosis and proximal muscle weakness in a female patient recently diagnosed with SLE, who evolved with associated MG.

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High Prevalence of Systemic Lupus Erythematosus in 78 Myasthenia Gravis Patients: A Clinical and Serologic Study

Cited by 49 publications

References 17 publications

Frequency of familial occurrence and associated autoimmune diseases in a cohort of patients with acquired autoimmune myasthenia gravis from Belgrade

Frequency of familial occurrence and associated autoimmune diseases in a cohort of patients with acquired autoimmune myasthenia gravis from Belgrade

Myasthenia gravis and multiple sclerosis: an uncommon presentation

Lúpus Eritematoso Sistêmico com fraqueza muscular por Miastenia Gravis

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