Raut Sumit, Reddy Ishani, Sahi Faryal Mustansir, Masood Ayesha, Malik Bilal Haider
Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Psychiatry and Behavioral Sciences, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Cureus. 2020 Jun 3;12(6):e8422. doi: 10.7759/cureus.8422.
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease and myasthenia gravis (MG) is an organ-specific autoimmune disease, both may exhibit positive anti-nuclear antibodies and a female preponderance. They may have similar features and can coexist in a patient or precede one another. This review article is based on electronic searches using PubMed as the primary database. Most of the articles used for this review were published in the last ten years with the exception of seven articles which were from 1995-2009. No guidelines have been followed. A total of 55 research articles were found related to the topic of this review article, and further scanning was done to eliminate some articles that did not meet the criteria. The coexistence of autoimmune diseases has been reported in many cases. The prevalence of a second autoimmune disease is higher among patients with a primary diagnosis of autoimmune disease than the general population. The prevalence of SLE in MG patients or vice-versa is greater than the general population. The association has been hypothesized to many mechanisms: thymectomy resulting in loss of central tolerance and generation of autoantibodies, regulatory T cell dysfunction, the dysregulated function of Fas receptor (CD95), anti-malarial drugs directly affecting the neuromuscular junction, the role of chemokine CXCL13 and GM-CSF in the pathogenesis. The association is rare, and the presence of one should be closely followed for further progression into other diseases. More research work needs to be done for a clear conclusion.
系统性红斑狼疮（SLE）是一种全身性自身免疫性疾病，重症肌无力（MG）是一种器官特异性自身免疫性疾病，两者都可能出现抗核抗体阳性且女性居多。它们可能有相似的特征，可在同一患者中共存或先后出现。这篇综述文章基于以PubMed为主要数据库的电子检索。用于本综述的大多数文章发表于过去十年，只有七篇文章来自1995年至2009年。未遵循任何指南。共找到55篇与本综述主题相关的研究文章，并进一步筛选以排除一些不符合标准的文章。自身免疫性疾病的共存已在许多病例中得到报道。初诊为自身免疫性疾病的患者中，第二种自身免疫性疾病的患病率高于普通人群。MG患者中SLE的患病率或反之亦然，均高于普通人群。这种关联被假设存在多种机制：胸腺切除术导致中枢耐受性丧失和自身抗体产生、调节性T细胞功能障碍、Fas受体（CD95）功能失调、抗疟药物直接影响神经肌肉接头、趋化因子CXCL13和粒细胞-巨噬细胞集落刺激因子（GM-CSF）在发病机制中的作用。这种关联很罕见，出现其中一种疾病时应密切关注是否会进一步发展为其他疾病。需要开展更多研究工作以得出明确结论。
