Multiple sclerosis and myasthenia gravis

Abstract

A 34-year-old woman with long-standing multiple sclerosis had a 2-year history and physical signs of myasthenia gravis. The edrophonium chloride (Tensilon) test was positive. Repetitive stimulation of the ulnar nerve at 3 Hz did not show evidence of myasthenic response; however, a single-fiber electromyography demonstrated evidence of neuromuscular block as seen in myasthenia gravis, which was reversed to normal after intravenously administered edrophonium. The patient improved on anticholinesterase medication. It is suggested that patients with multiple sclerosis who have unusual features such as in the patient reported here should be investigated for the presence of myasthenia gravis to ensure proper treatment.

Myasthenia Gravis and Recurrent Retrobulbar Optic Neuritis: An Unusual Combination of Diseases

“…If the association of MG with RON is exceptional, conversely reports of concur rence of MG with MS or of MS with electro myographic evidence of defective neuromus cular transmission are not so rare [Achari et al, 1976;Aita et al, 1974;Cendrowski, 1975;Chaco, 1974;Eisen et al, 1978;Kuligowski, 1938;Lo and Feasby, 1983;Margolis and Graves, 1945;Patten et al. 1972;Satoyoshi et al, 1975], In our case, there was no clinical or sero logic evidence for SLE.…”

“…1983;Loand Feasby, 1983], Reports of an association of MG with neurological diseases are very scarce: cases of MG arc described with concomitant epilepsy [Hoefer et al, 1958], acute polyneuropathy [Regev et al, 1982], retrobulbar optic neuritis (RON) [Ghezzi et al, 1984;Goldman et al, 1984] and multiple sclerosis (MS) [Achari et al, 1976;Aita et al, 1974;Cendrowski, 1975;Chaco, 1974;Eisen et al, 1978;Kuligowski, 1938;Lo and Feasby, 1983;Margolis and Graves, 1945;Patten et al, 1972;Satoyoshi et al, 1975], This paper describes a case in which a recurrent RON appeared in the course of MG.…”

Polyreactive myelin oligodendrocyte glycoprotein antibodies: Implications for systemic autoimmunity in progressive experimental autoimmune encephalomyelitis

“…Although involvement of general organs in MS has been reported, its implication in disease pathogenesis is not clear. In addition, demyelinating diseases similar to MS have been occasionally reported in systemic autoimmune diseases, such as autoimmune thyroid disease, myasthenia gravis, rheumatoid arthritis and systemic lupus erythematosus (SLE) (Achari et al, 1976;Aita et al, 1974;Meloff, 1980;Tanphaichitr, 1980). Hypocomplementemia and circulating immune complexes have also been demonstrated in MS (Tachovsky et al, 1976;Tanphaichitr, 1980).…”

Demyelinating disease in patients with myasthenia gravis

“…rarely, MG can be part of multiple autoimmune syndromes, including autoimmune diabetes mellitus, thrombotic thrombocytopenic purpura, sjögren syndrome, systemic lupus erythematosus, vitiligo, among other rare diseases 5 . In the past 20 years there has been an increasing number of reports on patients with MG presenting demyelinating diseases (dd) [6][7][8][9][10][11][12][13][14][15] , including multiple sclerosis, neuromyelitis optica (NMo), transverse myelitis and optic neuritis. however, it is not known whether this association is also part of unspecific immune activation, genetic susceptibility or if it just happens by random.…”