Neuromuscular Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Muscle Nerve. 2021 May;63(5):631-639. doi: 10.1002/mus.27118. Epub 2020 Nov 27.
Ocular myasthenia gravis (OMG) and thyroid eye disease are two autoimmune conditions that have several overlapping clinical features, and these coexist with a small but not insignificant frequency. Segregating these diagnoses is typically straightforward, but, when the two diseases co-occur in the same individual, making a diagnosis of OMG can be very challenging. In this review we address what is known about the coexistence of OMG and thyroid eye disease and we highlight the clinical features that are suggestive of overlapping conditions. We also describe the major testing approaches used in the diagnosis of these two entities, with special emphasis on the potential shortcomings of individual tests in patients with overlapping disease. In patients with thyroid eye disease, securing a diagnosis of OMG may not be possible on the basis of a single positive test. A multimodal approach using clinical, serologic, imaging, and electrodiagnostic data, is typically required.
眼肌型重症肌无力（OMG）和甲状腺眼病是两种自身免疫性疾病，具有许多重叠的临床特征，且这些疾病同时存在的频率虽小但并非微不足道。通常，区分这些诊断很简单，但当两种疾病同时发生在同一患者身上时，OMG 的诊断可能极具挑战性。在这篇综述中，我们探讨了 OMG 和甲状腺眼病共存的相关问题，并强调了提示重叠疾病的临床特征。我们还描述了用于诊断这两种疾病的主要检测方法，特别强调了在重叠疾病患者中，单一检测方法的潜在缺陷。在甲状腺眼病患者中，单凭一项阳性检测可能无法确诊 OMG。通常需要采用临床、血清学、影像学和电诊断数据的多模态方法。
