Aoki Sho, Nagashima Kazuaki, Furuta Minori, Makioka Kouki, Fujita Yukio, Saito Kazuma, Kashima Tomoyuki, Nakajima Nozomi, Ikota Hayato, Higuchi Osamu, Ikeda Yoshio
Department of Neurology, Gunma University Graduate School of Medicine, Japan.
Department of Ophthalmology, Gunma University, School of Medicine, Japan.
Intern Med. 2020 May 1;59(9):1219-1222. doi: 10.2169/internalmedicine.3828-19. Epub 2020 Feb 12.
We herein report the case of a 65-year-old woman diagnosed with myasthenia gravis (MG) after complaining of double vision. The patient had anti-low-density lipoprotein receptor-related protein 4 (LRP4) antibody in her serum, although antibodies against the acetylcholine receptor and muscle-specific tyrosine kinase were not detected. Chest computed tomography showed an anterior mediastinal tumor with a high uptake on fluorodeoxyglucose-positron emission tomography. Endoscopic thymectomy successfully ameliorated her ocular symptoms and showed the lesion to be thymoma. The present case revealed that anti-LRP4 antibody-associated MG can be associated with thymoma, which has been regarded as a rare complication of this disease thus far.
我们在此报告一例65岁女性病例，该患者在出现复视后被诊断为重症肌无力（MG）。患者血清中存在抗低密度脂蛋白受体相关蛋白4（LRP4）抗体，但未检测到抗乙酰胆碱受体和肌肉特异性酪氨酸激酶抗体。胸部计算机断层扫描显示前纵隔肿瘤，氟脱氧葡萄糖-正电子发射断层扫描显示该肿瘤摄取高。内镜下胸腺切除术成功改善了她的眼部症状，并显示病变为胸腺瘤。本病例表明，抗LRP4抗体相关的MG可能与胸腺瘤有关，而胸腺瘤迄今为止一直被视为该疾病的罕见并发症。
