Co-occurrence of Myasthenia Gravis and Multiple Sclerosis: A Case Report

Myasthenia gravis (MG) and multiple sclerosis (MS) are thought to have a common autoimmune mechanism as the number of reported co-occurrences of both diseases is increasing. The involvement of both T cells and B cells in the pathogenesis of these two diseases is suspected. As the symptoms and clini...

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Main Authors: G. Rynkevič, R. Kizlaitienė
Format: Article
Language:English
Published: Vilnius University Press 2024-02-01
Series:Neurologijos seminarai
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Online Access:https://www.journals.vu.lt/neurologijos_seminarai/article/view/34585
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author G. Rynkevič
R. Kizlaitienė
author_facet G. Rynkevič
R. Kizlaitienė
author_sort G. Rynkevič
collection DOAJ
description Myasthenia gravis (MG) and multiple sclerosis (MS) are thought to have a common autoimmune mechanism as the number of reported co-occurrences of both diseases is increasing. The involvement of both T cells and B cells in the pathogenesis of these two diseases is suspected. As the symptoms and clinical course of MS and MG can be similar in some cases, this makes it difficult to consider the possibility of the coexistence of these disorders. However, laboratory and imagining findings are helpful in distinguishing both diseases and differentiating them from other neurological conditions. Additionally, there can be obstacles in effective treatment selection for patients with MS and MG coexistence. This article presents a clinical case of a woman with previously diagnosed MG who was admitted to hospital 12 years later with new-onset symptoms and was additionally diagnosed with relapsing-remitting multiple sclerosis (RRMS). Remission of MG was achieved with medications and thymectomy, but treatment of MS had its challenges, as first-line immunomodulating drugs interferon beta-1a and dimethyl fumarate were not effective, and second line treatment with monoclonal antibody medication rituximab and ocrelizumab showed efficacy for both diseases, MG and MS. The presented case highlights the importance of considering a manifestation of another disease when treating an already diagnosed disorder. It also emphasizes the importance of further research into the relationship between MG and MS.  
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publisher Vilnius University Press
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spelling doaj-art-1471dadc3af348f6a7e9581f2b9f1bc52025-01-20T18:21:57ZengVilnius University PressNeurologijos seminarai1392-30642424-59172024-02-0127No. 2 (96)10.29014/NS.2023.27.13Co-occurrence of Myasthenia Gravis and Multiple Sclerosis: A Case ReportG. Rynkevič0R. Kizlaitienė1Vilnius University, LithuaniaVilnius University, Lithuania Myasthenia gravis (MG) and multiple sclerosis (MS) are thought to have a common autoimmune mechanism as the number of reported co-occurrences of both diseases is increasing. The involvement of both T cells and B cells in the pathogenesis of these two diseases is suspected. As the symptoms and clinical course of MS and MG can be similar in some cases, this makes it difficult to consider the possibility of the coexistence of these disorders. However, laboratory and imagining findings are helpful in distinguishing both diseases and differentiating them from other neurological conditions. Additionally, there can be obstacles in effective treatment selection for patients with MS and MG coexistence. This article presents a clinical case of a woman with previously diagnosed MG who was admitted to hospital 12 years later with new-onset symptoms and was additionally diagnosed with relapsing-remitting multiple sclerosis (RRMS). Remission of MG was achieved with medications and thymectomy, but treatment of MS had its challenges, as first-line immunomodulating drugs interferon beta-1a and dimethyl fumarate were not effective, and second line treatment with monoclonal antibody medication rituximab and ocrelizumab showed efficacy for both diseases, MG and MS. The presented case highlights the importance of considering a manifestation of another disease when treating an already diagnosed disorder. It also emphasizes the importance of further research into the relationship between MG and MS.   https://www.journals.vu.lt/neurologijos_seminarai/article/view/34585multiple sclerosismyasthenia gravisautoimmune diseasedemyelinating disease
spellingShingle G. Rynkevič
R. Kizlaitienė
Co-occurrence of Myasthenia Gravis and Multiple Sclerosis: A Case Report
Neurologijos seminarai
multiple sclerosis
myasthenia gravis
autoimmune disease
demyelinating disease
title Co-occurrence of Myasthenia Gravis and Multiple Sclerosis: A Case Report
title_full Co-occurrence of Myasthenia Gravis and Multiple Sclerosis: A Case Report
title_fullStr Co-occurrence of Myasthenia Gravis and Multiple Sclerosis: A Case Report
title_full_unstemmed Co-occurrence of Myasthenia Gravis and Multiple Sclerosis: A Case Report
title_short Co-occurrence of Myasthenia Gravis and Multiple Sclerosis: A Case Report
title_sort co occurrence of myasthenia gravis and multiple sclerosis a case report
topic multiple sclerosis
myasthenia gravis
autoimmune disease
demyelinating disease
url https://www.journals.vu.lt/neurologijos_seminarai/article/view/34585
work_keys_str_mv AT grynkevic cooccurrenceofmyastheniagravisandmultiplesclerosisacasereport
AT rkizlaitiene cooccurrenceofmyastheniagravisandmultiplesclerosisacasereport