Myasthenia in patients with dermatomyositis

Vasilescu, C; Bucur, G; Petrovici, A; Florescu, A.

doi:10.1016/0022-510x(78)90060-6

Cited by 23 publications

(2 citation statements)

References 20 publications

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“…In our literature review, we identified 20 cases of myositis-MG reported since 1976 (Table 1) (3–19). In the only prior report including more than one myositis-MG overlap case, Vasilescu and colleagues described four patients with clinical signs of DM, confirmed by muscle biopsy, who also had MG based on typical electrophysiological findings (4). However, these patients were described in 1978, before the availability of testing for anti-AChR or -MUSK antibodies.…”

Section: Discussionmentioning

confidence: 99%

The co-existence of myasthenia gravis in patients with myositis: A case series

Paik

Corse

Mammen

2014

Seminars in Arthritis and Rheumatism

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Objective Myositis and myasthenia gravis (MG) are both autoimmune disorders presenting with muscle weakness. Rarely, they occur simultaneously in the same patient. Since the management of myasthenia gravis differs from that of myositis, it is important to recognize when patients have both diseases. We reviewed the cases of 6 patients with both myositis and MG to identify clinical features that suggest the possibility of co-existing MG in myositis patients. Methods We identified 6 patients with dermatomyositis or polymyositis and MG. We reviewed their medical records to assess their clinical presentations, laboratory findings, and electrophysiological features. Results All 6 patients had definite dermatomyositis or polymyositis by the criteria of Bohan and Peter as well as electrophysiologic and/or serologic confirmation of MG. Among overlap patients, 5/6 (83%) had bulbar weakness, 2/6 (33%) had ptosis, and 1/6 (17%) had diplopia. Fatigable weakness was noted by 5/6 (83%) patients. Treatment with pyridostigmine improved symptoms in 5/6 (83%). High dose steroids were associated with worsening weakness in 2/6 (33%) patients. Conclusions Prominent bulbar symptoms, ptosis, diplopia, and fatigable weakness should suggest the possibility of MG in patients with myositis. A suspicion of MG may be confirmed through appropriate electrophysiologic and laboratory testing. In those with myositis-MG overlap, high dose steroids may exacerbate symptoms and pryidostigmine may play an important therapeutic role.

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Section: Discussionmentioning

confidence: 99%

The co-existence of myasthenia gravis in patients with myositis: A case series

Paik

Corse

Mammen

2014

Seminars in Arthritis and Rheumatism

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“…If the cases from different series are combined, 3.6% had evidence of one of these diseases (1). There are several reports on the coexistence of polymyositis, but only sporadic cases of dermatomyositis with MGhave been documented (2). Meanwhile, lupus anticoagulant (LA) antibodies might be detected in patients with MG (3).…”

Section: Introductionmentioning

confidence: 99%

Lupus Anticoagulant in Myasthenia Gravis Associated with IgM Gammopathy.

et al. 2001

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The plasma of a patient with myasthenia gravis had strong lupus anticoagulant activity and his IgM paraprotein displayed non-specific inhibition to coagulation factors IX, XI, XII, prekallikrein, and high molecular weight kininogen. He was placed on prednisolone, which resulted in improvement in his myasthenic symptoms, but the prolongation of APTTand macroglobulinemia remained. Double filtration plasmapheresis successfully decreased the serum IgM level from 1,190 mg/dl to 375 mg/dl and APTT improved from 58 s to 38 s. Myasthenia gravis is frequently associated with other autoimmunediseases, but the association with lupus anticoagulant and IgM gammopathyis rare. (Internal Medicine 40: 952-955, 2001)

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Inflammatory myopathies: Part 1

Mastaglia

Ojeda

1985

Annals of Neurology

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The inflammatory myopathies have diverse clinical and pathological features and multiple etiologies. Some are confined to a single muscle or group of muscles (e.g., orbital myositis and localized nodular myositis) while others are diffuse. Infective forms may be due to viral, bacterial, fungal, protozoal, or parasitic organisms. Viruses may cause acute self-limited forms of myositis and have been isolated from muscle in some cases of acute rhabdomyolysis and inclusion body myositis. They have also been implicated in some cases of congenital myopathy and in polymyositis and dermatomyositis, but there is no evidence of viral invasion of muscle in these conditions. In polymyositis and dermatomyositis there are derangements in humoral and cellular immune function, and recent evidence suggests an underlying disturbance of immunoregulation. The roles of genetic factors, drugs, and Toxoplasma infection have been under scrutiny. There is increasing recognition of immunological and pathological differences in polymyositis and juvenile and adult dermatomyositis, and in cases with associated connective tissue diseases, suggesting different underlying pathogenetic mechanisms. Inclusion body myositis, eosinophilic myositis, and granulomatous myositis can be separated from the other idiopathic inflammatory myopathies because of distinctive clinical and pathological features and this may also reflect different mechanisms of muscle injury. Recent developments in the treatment of the idiopathic inflammatory myopathies include the use of plasmapheresis and total-body irradiation in cases that are resistant to corticosteroids and immunosuppressive drugs.

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Myasthenia in patients with dermatomyositis

Cited by 23 publications

References 20 publications

The co-existence of myasthenia gravis in patients with myositis: A case series

The co-existence of myasthenia gravis in patients with myositis: A case series

Lupus Anticoagulant in Myasthenia Gravis Associated with IgM Gammopathy.

Inflammatory myopathies: Part 1

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