Systemic sclerosis complicated with left trigeminal neuropathy and myasthenia gravis during a period of six years after on-set

SSc who developed MG without prior exposure to d-penicillamine and, by reviewing similar cases, we discuss the true association of the two autoimmune diseases and the myth of d-penicillamine-induced MG. Case-report A 66-year-old Caucasian woman was referred to the neurology department because of unilateral eyelid ptosis, which was accompanied by generalized weakness and fatigue with diurnal variation. The patient suffered from SSc with skin involvement limited to the hands, feet and face which had been diagnosed 15 years before. She had been treated with d-penicillamine for the first 5 years, whereas during the last 10 years she was receiving low-dose aspirin, losartan, protonpump inhibitors and thyrormone. Neurophysiological testing showed positive decremental responses of compound muscle action potential to repetitive nerve stimulation on both the right orbicularis oculi and the right trapezius muscles. Immunological screening revealed elevated titers of antinuclear, anti-centromere and acetylcholine receptor (AChR) antibodies. Other standard antibodies were not found. A chest axial computed tomography did not reveal the presence of a thymoma or a thymus gland enlargement. A diagnosis of MG was set and pyridostigmine bromide 60 mg four times daily, along with prednisolone 20 mg and azathioprine 50 mg, were prescribed. One month later, the dose of azathioprine increased to 100 mg daily. After five months, the myasthenic symptoms had almost resolved. She continued

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Systemic sclerosis complicated with left trigeminal neuropathy and myasthenia gravis during a period of six years after on-set

Cited by 2 publications

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Myasthenia gravis and scleroderma: Two cases and a review of the literature

Myasthenia gravis and scleroderma: Two cases and a review of the literature

The True Association of Systemic Sclerosis with Myasthenia Gravis and the Myth of D-Penicillamine-Induced Myasthenia

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