Inatus A, Ohi T, Shioya K, Matsukura S
Department of Internal Medicine, Miyazaki Medical College.
Rinsho Shinkeigaku. 1992 Aug;32(8):878-9.
A 31-year-old woman noticed progressive muscular weakness in the limbs and paresthesia in the fingers in February 1989. Paresthesia worsened and improved 4 times during 2 months. Intravenous edrophonium chloride failed to improve her muscular weakness. She had high antiacetylcholine receptor antibody titer in serum. We made a diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) because of slow nerve conduction velocity (NCV), increased CSF protein, and the clinical course. Treatment with prednisolone improved muscular weakness and the slow NCV. Two years later she acutely had dyspnea, dysphagia, and muscular weakness after upper respiratory infection. Intravenous edrophonium chloride dramatically improved her symptoms. The diagnosis was made as myasthenia gravis (MG). After thymectomy her weakness was getting better without any medications. There may exist an autoimmune mechanism common, at least in part, to both CIDP and MG in our patient.
一名31岁女性于1989年2月出现四肢进行性肌无力及手指感觉异常。感觉异常在2个月内加重及缓解了4次。静脉注射氯化腾喜龙未能改善其肌无力。她血清中抗乙酰胆碱受体抗体滴度很高。由于神经传导速度（NCV）减慢、脑脊液蛋白升高及临床病程，我们诊断为慢性炎症性脱髓鞘性多发性神经根神经病（CIDP）。泼尼松龙治疗改善了肌无力及NCV减慢的情况。两年后，她在上呼吸道感染后急性出现呼吸困难、吞咽困难及肌无力。静脉注射氯化腾喜龙显著改善了她的症状。诊断为重症肌无力（MG）。胸腺切除术后，她的肌无力在未使用任何药物的情况下逐渐好转。在我们的患者中，可能至少部分存在一种CIDP和MG共同的自身免疫机制。
