Myasthenia gravis followed by systemic lupus erythematosus

Denney, Duane; Rose, Raymond L.

doi:10.1212/wnl.11.8.710

Cited by 33 publications

(7 citation statements)

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“…The first diagnosis was SLE in eight patients (47%) with a median time to MG of 4 years [0. [3][4][5][6][7][8][9][10][11][12][13], MG in eight (47%) with a median time to SLE of 6.5 years , whereas diagnosis of both diseases was concomitant in one. Other associated autoimmune diseases were found in five patients (pernicious anemia in two cases, vitiligo in two, thyroiditis in one, autoimmune hypoglycemia in one, and Sjögren's syndrome in one).…”

Section: Resultsmentioning

confidence: 99%

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The association of systemic lupus erythematosus and myasthenia gravis: a series of 17 cases, with a special focus on hydroxychloroquine use and a review of the literature

et al. 2011

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The coexistence of systemic lupus erythematosus (SLE) and myasthenia gravis (MG) is rarely reported, and most of the published studies are case reports. Hydroxychloroquine, an antimalarial agent, is an essential treatment in patients with SLE but special caution is recommended when used in MG patients. We retrospectively analyzed the clinical features, laboratory findings, and outcome of 17 patients with both diseases with a special focus regarding hydroxychloroquine use and with a review of the literature. All patients were women. The mean age at MG onset and SLE diagnosis was 34.5 [14-64] and 37.8 [18-72] years, respectively. The presenting symptoms of MG were limb weakness (94%), ocular (88%) and bulbar involvement (53%). Autoantibodies against the acetylcholine receptor were positive in 94% of cases. The main manifestations of SLE included arthritis (88%), cytopenias (53%) and skin rash (41%). Treatment of SLE required hydroxychloroquine (94%), steroids (47%) and immunosuppressive drugs (18%). Among eight patients (47%) who developed MG after initiation of hydroxychloroquine, the question of induction of MG by hydroxychloroquine was raised in one patient. On the other hand, an exacerbation of myasthenic symptoms was only seen in one of the eight patients who received hydroxychloroquine after the diagnosis of MG. Including our cases, we reviewed a total of 70 patients with SLE and MG. Compared with a large series of 1,000 unselected SLE patients, those with associated MG were older, had lower incidence of cutaneous, renal, and neurological manifestations, and higher frequency of anticardiolipin antibodies and lupus anticoagulant. In conclusion, the clinical pattern of patients with SLE and MG seems to be characterized by a less severe course of SLE and higher frequency of antiphospholipid antibodies. Hydroxychloroquine treatment appears to be safe in this setting.

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Section: Resultsmentioning

confidence: 99%

“…Six patients (35.3%) developed SLE following thymectomy after a median time of 3.8 years [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Section: Systemic Lupus Erythematosusmentioning

confidence: 99%

The association of systemic lupus erythematosus and myasthenia gravis: a series of 17 cases, with a special focus on hydroxychloroquine use and a review of the literature

et al. 2011

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“…Recent ex periments also established that the thymus has an immunologic rather than an endocrine function [4,5]. A clinical association between my asthenia gravis and systemic lupus erythematosus has been reported by Harvey et al [3] and Denney and Rose [1]. Furthermore, White and Marshall [10] found, in a group of 16 patients with myasthenia gravis, in 6 of them an antinuclear factor using the fluorescent-antibody technique.…”

Section: Discussionmentioning

confidence: 97%

Muscle and Thymus Antibodies in Myasthenia gravis

Geld¹,

Oosterhuis²

1963

Vox Sanguinis

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“…Section of the gland from this case showed some evidence of thyrolditis. Harvey et al (1954), Denney and Rose (1961), and White et al (1961) have pointed to the association of myasthenia gravis and lupus erythematosus. White and Marshall (1962) demonstrated the presence of antinuclear factor in six myasthenic patients, of whom one had and another probably had lupus erythematosus.…”

Section: Discussionmentioning

confidence: 99%