Nakamagoe Kiyotaka, Furuta Jun-Ichi, Shioya Ayako, Tamaoka Akira
Department of Neurology, Institute of Clinical Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.07.2009.2091. Epub 2009 Dec 9.
This is a report of a 64 year-old male patient whose myasthenia gravis (MG) was accompanied by vitiligo vulgaris. Depigmentation of the face, trunk, and hands was noted. He was diagnosed with vitiligo vulgaris according to macroscopic findings and a skin biopsy. He was also found to have blepharoptosis, and proximal dominant muscle weakness of the extremities. He was anti-acetylcholine receptor antibody-positive, with repetitive nerve stimulation showing a waning phenomenon and chest computed tomography showing invasive thymoma, which led to the diagnosis of generalised MG. His myasthenic symptoms were relieved by the use of steroids and the removal of the thymoma. His vitiligo vulgaris began to improve a month after the relief of myasthenic symptoms. Such improvement was pronounced during the next several months. The clinical or immunological relationship between MG and vitiligo vulgaris is still not known, but these findings might indicate clinical correlation between MG and vitiligo vulgaris.
这是一份关于一名64岁男性患者的报告,该患者患有重症肌无力(MG)并伴有寻常型白癜风。患者面部、躯干和手部出现色素脱失。根据肉眼观察结果和皮肤活检,他被诊断为寻常型白癜风。此外,还发现他有上睑下垂以及四肢近端为主的肌肉无力。他的抗乙酰胆碱受体抗体呈阳性,重复神经电刺激显示递减现象,胸部计算机断层扫描显示侵袭性胸腺瘤,从而确诊为全身型MG。使用类固醇药物并切除胸腺瘤后,他的重症肌无力症状得到缓解。在重症肌无力症状缓解一个月后,他的寻常型白癜风开始改善。在接下来的几个月里,这种改善非常明显。MG与寻常型白癜风之间的临床或免疫关系尚不清楚,但这些发现可能表明MG与寻常型白癜风之间存在临床关联。