J Korean Rheum Assoc.  2010 Dec;17(4):437-441. 10.4078/jkra.2010.17.4.437.

Co-occurrence of Myasthenia Gravis in a Patient with Systemic Sclerosis-Sjogren's Syndrome without D-penicillamine Therapy

• Cha MS
• Choi YR
• Kwak MS
• Lee CH
• Cho JH
• Choi IS
• Kim SJ

• KMID: 2201905
• DOI: http://doi.org/10.4078/jkra.2010.17.4.437

Abstract

Systemic sclerosis is an autoimmune disease characterized by progressive fibrosis of the skin and visceral organs. Myasthenia gravis is also an autoimmune disease characterized by weakness and fatigue of skeletal muscles. The symptoms of systemic sclerosis and myasthenia gravis overlap clinically, so the recognition of disease co-occurrence may be delayed. Co-occurrence of myasthenia gravis and systemic sclerosis is very uncommon and usually diagnosed after use of D-penicillamine for treating the systemic sclerosis. We report a case of a 49-year-old female patient who complained of general weakness and was diagnosed with myasthenia gravis. Four months earlier she was diagnosed with systemic sclerosis with Sjogren's syndrome and her medications did not include D-penicillamine.

Keyword

Scleroderma; Myasthenia gravis; Sjogren's syndrome

MeSH Terms

Autoimmune Diseases
Fatigue
Female
Fibrosis
Humans
Middle Aged
Muscle, Skeletal
Myasthenia Gravis
Penicillamine
Scleroderma, Systemic
Sjogren's Syndrome
Skin
Penicillamine

Figure

• 

  Fig. 1. Salivary gland scan showed diffusely decreased uptake of radiotracer in the bilateral parotid (arrows) and submandibular glands (arrow heads).

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  Fig. 2. Repetitive nerve stimulation test revealed a decremental response in the right flexor carpi ulnaris muscle of more than 10% at a low stimulation rate (5 Hz), (A) but no decremental response in the right orbicularis oculi muscle (B).

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