A case of myasthenia gravis following sarcoidosis and rheumatoid arthritis

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  • Sawada Jun
    Division of Neurology, Department of Internal Medicine, Asahikawa Medical University Department of Neurology, Nayoro City General Hospital
  • Asanome Asuka
    Division of Neurology, Department of Internal Medicine, Asahikawa Medical University
  • Endo Hisako
    Division of Neurology, Department of Internal Medicine, Asahikawa Medical University
  • Saito Tsukasa
    Division of Neurology, Department of Internal Medicine, Asahikawa Medical University
  • Katayama Takayuki
    Division of Neurology, Department of Internal Medicine, Asahikawa Medical University
  • Hasebe Naoyuki
    Division of Neurology, Department of Internal Medicine, Asahikawa Medical University

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Other Title
  • 関節リウマチとサルコイドーシスに重症筋無力症が合併した1例
  • 症例報告 関節リウマチとサルコイドーシスに重症筋無力症が合併した1例
  • ショウレイ ホウコク カンセツ リウマチ ト サルコイドーシス ニ ジュウショウキン ムリョクショウ ガ ガッペイ シタ 1レイ

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Abstract

We report an elderly woman with sarcoidosis and rheumatoid arthritis who subsequently developed myasthenia gravis. She was given a diagnose of rheumatoid arthritis at the age of 65 years and sarcoidosis, proved by multiple lymphadenopathy with noncaseating granuloma at the age of 67. Prednisolone, methotrexate, and etanercept had been administrated for rheumatoid arthritis. She consulted our hospital because of bilateral ptosis with diurnal fluctuation at the age of 72. Myasthenia gravis was confirmed by an elevated serum anti-acetylcholine receptor antibody titer (1,100 nmol/l, normal <0.2) and a positive edrophonium test. A chest CT showed a small granular structure in the anterior mediastinum, suggesting thymic hyperplasia. This is the first reported case of myasthenia gravis complicated by sarcoidosis and rheumatoid arthritis. Administration of etanercept may be involved in the onset of myasthenia gravis.

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 53 (5), 351-355, 2013

    Societas Neurologica Japonica

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