A 58-year-old woman was admitted to the neurology clinic in 1999 with asymmetric ptosis, weakness in both arms and legs, inability to hold the neck, and speech disorders. In her neurological examination, it was determined that tetraparesis, bilateral asymmetric ptosis, binocular diplopia after physical effort, and nasone speech, able to count to 20 before his voice became inaudible. An electromyography (EMG) study Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by persistent synovitis, systemic inflammation, and the presence of autoantibodies. Inhibitors of tumor necrosis factor (TNF)-alpha are widely used for treating RA. However, prolonged use of these agents has been associated with induction some autoimmune disease. Here, we have shown that anti-TNF drugs used in long-term follow-up of two patients diagnosed with both RA and myasthenia gravis, are safely.