J Clin Neurol.  2010 Dec;6(4):224-226. 10.3988/jcn.2010.6.4.224.

Myasthenia Gravis Aggravated by Steroid-Induced Isolated Mediastinal Tuberculous Lymphadenitis

Affiliations
  • 1Department of Neurology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
  • 2Department of Neurology, Chonnam National University Medical School, Gwangju, Korea. kcho@chonnam.ac.kr

Abstract

BACKGROUND
Myasthenia gravis (MG) is occasionally aggravated by chronic infection, of which there are many kinds.
CASE REPORT
We report herein the case of a 56-year-old woman with MG aggravated by the activation of isolated mediastinal tuberculous lymphadenitis (MTL) during corticosteroid administration. The possibility of MTL had been disregarded in the differential diagnosis of aggravation of MG weakness, because MTL without pulmonary manifestations is uncommon even in areas where tuberculosis is endemic.
CONCLUSIONS
This case suggests that chronic infections such as tuberculosis should be considered in myasthenic patients with progressive exacerbation if definite evidence for aggravating factors of MG is not obtained.

Keyword

tuberculous lymphadenitis; myasthenia gravis; steroids

MeSH Terms

Diagnosis, Differential
Female
Humans
Middle Aged
Myasthenia Gravis
Steroids
Tuberculosis
Tuberculosis, Lymph Node
Steroids

Figure

  • Fig. 1 The contrast-enhanced computed tomography images of the chest in the patient with mediastinal tuberculous lymphadenitis. A: Multiple lymphadenopathies with conglomerate and homogenous enhancement in the anterior mediastinum, right lower paratracheal area, and aortopulmonary window. B and C: Enlarged lymph nodes with central low attenuation and peripheral rim enhancement in both hilar areas (arrow)


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