Relation of Myasthenia Gravis to Hyperthyroidism

Thyrotoxic muscle disease

“…Myasthenia gravis precedes the thyroid disease in a third to just under a half and in 9-20% the onset of both is simultaneous (Millikan & Haines, 1953;Grob, 1963). Although McEachern & Parnell (1948) described a 'see-saw' relationship between the diseases, the myasthenia increasing as the thyrotoxicosis diminishes and viceversa, only three reports have supported this concept (Thorner, 1939;Cohen, 1946;Maclean & Wilson, 1954). The majority of opinion concludes that both diseases move in parallel or show no obvious pattern of interaction (Thorn & Tierney, 1941;Kowallis, Haines & Pemberton, 1942;Flynn, 1944; Greene, 1949;Millikan & Haines, 1953;Engel, 1961b, Osserman & Silver, 1961.…”

The Thyroid, the Thymus and Autoimmunity

“…However, autoimmune phenomena in thvroid disorders are not encountered solelv in as;ociation with Hashimoto's disease and 1;rimary myxoedema. Thus, thyrotoxicosis has been reported in association \\•ith myasthenia gravis (Rennie 1908 : Cohen andKing 1932 ;Thorner 1939 ;'.\IcEachern andParnell 19+8 : Bartels andKingsley 1949 : Greene 1949 ;Levy ct al, 1951 ;'.\1illikan and Haines 1953 ;Maclean and Wilson 1954;Silver and Osserman 1957 ;Engel 1961 ;Osserman and Silver 1961 ;Simpson 1964 ;Sahey ct al. 1965), pernicious anaemia (Wilkinson 1949;Tuclhope and \Vilson 1960;McNicol 1961 ;Tuelhope and Wilson 1%2 ;Doniach ct al.…”

“…However, autoimmune phenomena in thyroid disorders are not encountered solely in association with Hashimoto's disease and primary myxoedema. Thus, thyrotoxicosis has been reported in association with myasthenia gravis (Rennie 1908 : Cohen and King 1932 ; Thorner 1939 ; McEachern and Parnell 1948 ; Bartels and Kingsley 1949 ; Greene 1949 ; Levy et al 1951 ; Millikan and Haines 1953 ; Maclean and Wilson 1954 ; Silver and Osserman 1957 ; Engel 1961 ; Osserman and Silver 1961 ; Simpson 1964 ; Sahey et al 1965), pernicious anaemia (Wilkinson 1949 ; Tudhope and Wilson 1960 ; McNicol 1961 ; Tudhope and Wilson 1962 ; Doniach et al 1963 ; Sharpstone and James 1965) and idiopathic Addison's disease (Frederickson 1951 ; Decourt et al , 1957 : Rupp and Paschkis 1957 ; Frey 1959 ; Plamondon and Brunet 1959 ; Jenkins et al 1960; Greenberg 1961; Bruno et al 1962; Gabrilove and Weiner 1962; Irvine 1963). Moreover, focal thyroiditis, itself a frequent finding in association with pernicious anaemia (Bastenie 1937 ; Williams and Doniach 1962; Lee et al 1964), idiopathic Addison's disease (Schmidt 1926; Wells 1930; Sloper 1953 ; Blizzard and Kyle 1963) and myasthenia gravis (Simpson 1964) is a frequent accompaniment of primary and secondary thyrotoxicosis and some workers have been able to correlate the degree of lymphoid infiltration of the thyroid with a tendency to develop hypothyroidism post‐operatively (Whitesell and Black 1949 ; Greene 1950 and 1953).…”