Gharagozli Kurosh, Shojaei Maziar, Harandi Ali Amini, Akbari Nayyereh, Ilkhani Manouchehr
Loghman Hospital, Shahid Beheshti University of Medical Sciences, 13336-31151 Tehran, Iran.
Case Rep Med. 2011;2011:291731. doi: 10.1155/2011/291731. Epub 2011 May 18.
During the last decade, sporadic combination of multiple sclerosis (MS) and myasthenia gravis (MG) has been reported repeatedly. Although these are anecdotal, they are important enough to raise concerns about co-occurrence of MG and MS. Here, we present a case of an MS patient who developed an MG crisis. She had received interferon for relapsing remitting MS. Interestingly, she developed an MG crisis 4 years after the diagnosis of MS. MS and MG have relatively the same distribution for age, corresponding to the younger peak of the bimodal age distribution in MG. They also share some HLA typing characteristics. Furthermore, some evidences support the role of systemic immune dysregulation due to a genetic susceptibility that is common to these two diseases. The association may be underdiagnosed because of the possible overlap of symptoms especially bulbar manifestations in which either MG or MS can mimic each other, leading to underestimating incidence of the combination. The evidence warrants physicians, especially neurologists, to always consider the possibility of the other disease when encountering any patients either with MS or MG. Anecdotal and sporadic reports of combination of multiple sclerosis (MS) and myasthenia gravis (MG) have been raised concerns about co-occurrence of them.
在过去十年间，多发性硬化症（MS）与重症肌无力（MG）的偶发合并情况已被多次报道。尽管这些都是个案，但足以引发对MG和MS共病情况的关注。在此，我们报告一例发生MG危象的MS患者。她曾接受干扰素治疗复发缓解型MS。有趣的是，她在被诊断为MS 4年后发生了MG危象。MS和MG在年龄分布上相对相同，都对应于MG双峰年龄分布中的年轻高峰。它们还具有一些HLA分型特征。此外，一些证据支持由于这两种疾病共有的遗传易感性导致全身免疫失调所起的作用。由于症状可能重叠，尤其是延髓症状，MG和MS可能相互模仿，导致对这种合并情况的发病率估计不足，这种关联可能未得到充分诊断。有证据表明，医生，尤其是神经科医生，在遇到任何MS或MG患者时，都应始终考虑到另一种疾病的可能性。多发性硬化症（MS）与重症肌无力（MG）合并的个案和零星报道引发了对它们共病情况的关注。
