We report on a case of refractory myasthenia gravis that was managed by using intravenous immunoglobulin. A 35-year-old Chinese woman with malignant thymoma-associated myasthenia gravis was treated by total thymectomy, followed by chemotherapy. Thirty months later, she developed respiratory failure and required mechanical ventilation for 2 months. A course of intravenous immunoglobulin was give...

A family is reported in which myasthenia gravis and thyroid disease occur over three generations. The grandmother and granddaughter have ocular myasthenia and an aunt in the second generation had generalised myasthenia gravis with a thymoma. The pattern of histocompatibility antigens (HLA) haplotypes, anti-AChR antibodies, anti-striate muscle antibodies and thyroid disease is described. The hap...

1 Batocchi AP, Evoli A, Servidei S, Palmisani MT, Apollo F, Tonali P. Myasthenia gravis during interferon alfa therapy. Neurology 1 995;45:382-3. 2 Riedel RR, Schmitt A, Hartmann A. Ocular pseudo-myasthenic reaction induced by interferon in an AIDS patient. Kin Wochenschr 1991;69:930-1. 3 Fritze D, Herrman JRC, Naeim F, Smith GS, Zeller E, Walford RL. The biological significance of HL-A antigen...

Myasthenia gravis is an autoimmune disease of the postsynaptic membrane, especially acetylcholine receptors in neuromuscular link skeletal muscle. Patients with myasthenia have a high number globally. The occurs due to disorder that impairs impulse connection between chemicals traveling from nerve endings and receptors. Clinical symptoms include weakness eye muscles (ptosis diplopia), difficult...

The nicotinic acetylcholine receptor (AChR) is a large membrane protein found in muscle cells. It is involved in the transformation of acetylcholine packets into a membrane depolarization, which thereby leads to a muscle twitch. This large, complex molecule is the target of the autoimmune attack in myasthenia gravis, and much has been learned in the past decade about myasthenia by the induction...

Myasthenia gravis (MG) is the most common autoimmune disease affecting the neuromuscular junction and is characterized by ocular, bulbar, limb and respiratory muscle involvement. Some of the drugs may induce and exacerbate MG. Antibiotics are also one of the most important medication groups that may worsen MG and they should be used with caution in these patients with MG. Herein, we would like ...

A 52 year old man with myasthenia gravis and normal liver function was treated with neostigmine, prednisolone and azathioprine. Three years after starting azathioprine he developed clinical evidence of portal hypertension. A liver biopsy showed nodular regenerative hyperplasia (NRH). The development of NRH following azathioprine treatment in a patient with myasthenia gravis strengthens the case...

A 49-year-old female presents with ptosis, diplopia and dysphagia and is diagnosed with myasthenia gravis by electromyography (Figure 1). The patient reports some improvement of her symptoms with pyridostigmine, but due to increasing symptoms, she has been placed on prednisone and mycophenolate mofetil. She is otherwise healthy and takes no other medications. Computed tomography imaging shows n...

Myasthenia gravis and hypokalemic periodic paralysis are commonly related with hyperthyroidism but rarely occur together. Here, the authors reported a case of hypokalemic periodic paralysis in a Northeastern Thai woman accompanied with myasthenia gravis. She had motor weakness despite a normal level of serum potassium. Prostigmine test was positive. She dramatically improved after pyridostigmin...

We report the case of an unusual presentation of myasthenia gravis with tongue atrophy and fasciculation. Myasthenia gravis is an autoimmune condition associated with weakness and fatigability of voluntary muscles. In >50%, the initial symptoms and signs are related to extraocular muscle weakness, such as diplopia or ptosis [Tsung K, Seggev JS. An unusual cause of dysphagia. West J Med 1995; 16...