Neurol Sci. 2013 Jul;34(7):1249-50. doi: 10.1007/s10072-012-1201-z. Epub 2012 Sep 26.
Myasthenia gravis is a disorder of neuromuscular transmission caused by autoimmune mechanisms. We reported a possible association between seropositive myasthenia gravis and Kaposi's sarcoma in a HIV-negative subject and the observed interactions between the treatment regimen for these two conditions. A 62-year-old man came to our attention for ocular myasthenia gravis. He suffered from a classic form of Kaposi's sarcoma since about 1 year. When myasthenic symptoms worsened, the patient was started on prednisone and azathioprine. The patient had a significant worsening of Kaposi's sarcoma, so prednisone and azathioprine were reduced and he was treated with vinblastine, with improvement both in dermatologic than in neurological symptomatology. We propose some considerations: the potential correlation between Kaposi's sarcoma and myasthenia gravis through immunological mechanism; myasthenia gravis as a paraneoplastic manifestation of Kaposi's sarcoma, and the role of an antitumoral agent as a treatment for both the conditions.
重症肌无力是一种由自身免疫机制引起的神经肌肉传递障碍。我们报告了一例 HIV 阴性患者血清阳性重症肌无力与卡波西肉瘤之间可能存在的关联，以及这两种疾病的治疗方案之间的观察到的相互作用。一位 62 岁的男性因眼肌型重症肌无力引起了我们的注意。他大约在 1 年前患有典型的卡波西肉瘤。当肌无力症状恶化时，开始给他服用泼尼松和硫唑嘌呤。患者的卡波西肉瘤明显恶化，因此减少了泼尼松和硫唑嘌呤的用量，并开始用长春碱治疗，皮肤和神经症状都有所改善。我们提出了一些考虑因素：通过免疫机制，卡波西肉瘤和重症肌无力之间存在潜在的相关性；重症肌无力是卡波西肉瘤的副肿瘤表现，抗肿瘤药物在这两种疾病的治疗中都发挥了作用。
