A case of myasthenia gravis accompanied with hasimato thyroiditis and familial mediterranean fever

Familial mediterranean fever (FMF), Hasimato’s thyroiditis (HT) ve Myastenia gravis (MG) are chronical diseases that show autoimmunity. Literature reviews indicate several cases of coexisting MG and HT and only one case coexistence of MG and FMF. We present a clinical table of a 21-year-old male patient with all three diseases. The patient admitted to the hospital with limited eye movements, difficulty in swallowing which became evident towards the end of a meal. The patient had a history of FMF. The anti-TPO and anti-TG levels of the patient had increased. The ACh Receptor antibody was in the normal range (0.01), and the anti-MuSK value was high (>12). Single f iber EMG results of the patient were compatible with myasthenia gravis. The methylprednisolone and pyridostigmine treatment led to an almost complete improvement of the symptoms. As the patient had three different autoimmune disorders at once, it was thought to be a notable case worth presenting.

___

Verschuuren J, Palace J, Gilhus NE. Clinical aspects of myasthenia explained. Autoimmunity. 2010;43:344-352).

Kiss MH, Magalhaes CS. Autoinflammatory diseases: mimics of autoimmunity or part of its spectrum? Case presentation. J Clin Immunol. 2008;28:84-9.

Stassi G, DeMaria R. Autoimmune thyroid disease: new models of cell death in autoimmunity. Nat Rev Immunol. 2002;2:195-204.

Christensen PB, Jensen TS, Tsiropoulos I, et al. Associated autoimmune diseases in Myasthenia gravis. A population-based study. Acta Neurologica Scandinavica. 1995;91:192-5.

Evoli A, Padua L. Diagnosis and therapy of Myasthenia gravis with antibodies to muscle-spesific kinase. Autoimmun Rev. 2013:12:931-5.

Granel B, Seratrice J, Dode C, et al. Overlap syndrome between FMF and TRAPS in patient carrying MEFV and TNFRSF1A mutations. Clin Exp Rheumatol. 2007;25:45:93-5.

Karanikas G, Schuetz M, Wahl K, et al. Relation of anti-TPO autoantibody titre and T-lymphocyte cytokine production patterns in hashimoto’s thyroiditis. Clin Endocrinol. 2005;63:191-6.

Ohno M, Hamada N, Yamakawa J et al. Myasthenia gravis associated Graves’ disease in japan. Jpn J Med. 1987;26;2-6.

Simpson JA . Scot Med. 1960;7:419.

Singer W, Sahay BM. Myasthenia gravis, hashimoto’s thyroiditis and pernicious anaemia. Brit Med. 1966;1:904.

Kanawaza M, Shimohata T, Tanaka K, et al. Clinical features of patients with Myasthenia gravis associated with autoimmune diseases. Eur J Neurol. 2007;14:1403-4.

Kubiszewska J, Szyluk B, Szczudlik P, Bartoszewick Z et al. Prevalence and impact of autoimmune thyroid disease on Myasthenia gravis course. Brain Behavior. 2016;6:e00537.

Nakata R, Motomura M, Masuda T et al. Thymus histology and concomitant autoimmune diseases in Japanese patients with muscle-specific receptor tyrosine-antibody-positive Myasthenia gravis. Eur J Neurol. 2013;20:1272-6.

Toth C, McDonald D, Oger J, et al. Acetylcholine receptor antibodies in Myasthenia gravis are associated with greater risk of diabetes and thyroid disease. Acta Neurol Scandinavica. 2006;114:124-32.

Koge J, Hayashi S, Murai H et al. Morvan’s syndrome and Myasthenia gravis related to familial Mediterranean fever gene mutations. J Neuroinflmamation. 2016;13:68.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: 4
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
Sayıdaki Diğer Makaleler

Evaluation of strabismus surgery effects on anterior segment measurements using pentacam

Mehmet MURAT, Nilay CELEBİ, Çetin Akpolat

Aortic cross - clamp duration in cardiopulmonary bypass oxidative stress relationship

Zinet Asuman ARSLAN ONUK

Diagnostic utility of microhematuria in renal colic patients in emergency medicine: correlation with findings from multidetector computed tomography

Murat DAŞ, Okan BARDAKÇI, Ersan YURTSEVEN, Canan AKMAN, YAVUZ BEYAZİT, Okhan AKDUR

Prevalence of dysmenorrhea in young women and their coping methods

Aynur KİZİLİRMAK, Bahtisen KARTAL, Pelin CALPBİNİCİ

Static and dynamic balance between older individuals with and without chronic low back pain at the University College Hospital, Ibadan

Ayodeji Ayodele FABUNMİ, Oluwafikemi Adedolapo BADMUS

Evaluating clinical and radiological results following surgical treatment of patella fractures

Sadullah TURHAN, Yetkin SOYUNCU

Intensive care nurses’ perception of care concept the case of Turkey: A qualitative study

Veysel TEKİN, Ulviye GÜNAY

Efficacy and safety of intravitreal aflibercept therapy in diabetic macular edema

Ali Cihat ASLAN, Serkan ERDENOZ, Akin CAKİR, Burak ERDEN, Çetin Akpolat, Mustafa ELCİOĞLU

Lichenoid hypersensitivity reaction against to dental amalgam: Case report

Merve Nur GUVENC, Emine TÜRKMEN ŞAMDANCI, Ayşe Nur AKATLI, Eren ERDOGAN, Umit YOLCU

Evaluation of the relationship between health belief of breast cancer screening and health anxiety; A cross-sectional study

Meryem ASKİN, Esra KOÇ, Merve Yekta ATES, Mehmet ARSLAN, Gizem DAG, Ali Murat KOÇ, Melih Kaan SÖZMEN