Quan Weiwei, Xia Junhui, Tong Qiuling, Lin Jie, Zheng Xiaolu, Yang Xuezhi, Xie Dewei, Weng Yiyun, Zhang Xu
a Department of Neurology , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.
Int J Neurosci. 2018 Jun;128(6):570-572. doi: 10.1080/00207454.2017.1398160. Epub 2017 Nov 16.
To investigate the clinical character, diagnosis and treatment of chronic inflammatory demyelinating polyneuropathy accompanying myasthenia gravis so as to improve the understanding of such diseases.
A case of chronic inflammatory demyelinating polyneuropathy combined with myasthenia gravis were analyzed retrospectively with review of the literature.
This man was presented with chronic progressive sensory symptoms, flaccid tetraparesis, areflexia and protein-cell dissociation of cerebrospinal fluid. Nerve conduction study was indicative of demyelinating neuropathy. He was suspected as chronic inflammatory demyelinating polyneuropathy and treated with high-dose glucocorticoids. However, his condition worsened. Four months later, he was admitted and was diagnosed as combination of chronic inflammatory demyelinating polyneuropathy and myasthenia gravis. Good clinical results were observed after he was treated with pyridostigmine bromide, prednisone and mycophenolate mofetil.
This case warns clinicians to be aware of these two diseases presenting in the same patient, and the possible implications on treatment choices. A common immunological abnormality might exist in this rare association, but it still remains unknown.
探讨慢性炎症性脱髓鞘性多发性神经病合并重症肌无力的临床特点、诊断及治疗，以提高对此类疾病的认识。
回顾性分析1例慢性炎症性脱髓鞘性多发性神经病合并重症肌无力患者的临床资料，并复习相关文献。
该患者表现为慢性进行性感觉症状、四肢弛缓性瘫痪、腱反射消失及脑脊液蛋白细胞分离。神经传导检查提示脱髓鞘性神经病。最初怀疑为慢性炎症性脱髓鞘性多发性神经病，给予大剂量糖皮质激素治疗，但病情恶化。4个月后入院，诊断为慢性炎症性脱髓鞘性多发性神经病合并重症肌无力。给予溴吡斯的明、泼尼松及霉酚酸酯治疗后，临床效果良好。
该病例提醒临床医生注意同一患者可能同时存在这两种疾病，以及对治疗选择的潜在影响。这种罕见关联中可能存在共同的免疫异常，但仍不清楚。
