Iori Erika, Mazzoli Marco, Ariatti Alessandra, Salviato Tiziana, Rispoli Vittorio, Valzania Franco, Galassi Giuliana
Department of Biomedical, Metabolic Neural Sciences, University of Modena, Modena, Italy.
Department of Anatomy Pathology and Legal Medicine, University of Modena, Modena, Italy.
Int J Neurosci. 2024 May;134(5):429-435. doi: 10.1080/00207454.2022.2107517. Epub 2022 Sep 4.
The concomitant diagnosis of Parkinson's disease (PD) and Myasthenia Gravis (MG) is rare. The aim of the study was to report our experience of patients with both diagnoses.
We performed a retrospective analysis of patients with MG and PD, seen at Neurology Department, Modena, Italy from 2000 to 2020. We encountered 12 patients with both diagnoses. All had late onset MG (LOMG) and low Myasthenia Gravis Foundation of America (MGFA) severity scores at baseline. In respect of PD assessement, clinical signs were followed and summarized with modified Hoehn and Yahr staging (mHY). Patients were ranked as progressive or non-progressive, according to any change in mHY staging. We compared characteristics and outcome of the patients with age matched myasthenic subjects without PD.
The male gender significantly prevailed ( < 0.01) as well as the presence of multiple comorbidities ( < 0.001) in patients with MG associated with PD. In respect of clinical course, MG was benign as most of cases remained stable (66.7%). Six cases showed worsening of mHY scores; only one subject became wheelchair bound by the end of follow up. This uneven progression, at least in our hands, might suggest that MG and PD can evolve independently.
Clinicians should be alert about the association of PD and MG since early diagnosis and treatment are essential.
帕金森病（PD）和重症肌无力（MG）的合并诊断较为罕见。本研究的目的是报告我们对同时患有这两种疾病患者的诊治经验。
我们对2000年至2020年期间在意大利摩德纳神经病学部门就诊的MG和PD患者进行了回顾性分析。我们遇到了12例同时患有这两种疾病的患者。所有患者均为晚发型MG（LOMG），且基线时美国重症肌无力基金会（MGFA）严重程度评分较低。关于PD评估，采用改良Hoehn和Yahr分期（mHY）对临床体征进行跟踪和总结。根据mHY分期的任何变化，将患者分为进展性或非进展性。我们比较了患有PD的MG患者与年龄匹配的无PD的MG患者的特征和结局。
与PD相关的MG患者中男性明显居多（<0.01），且合并多种疾病的情况也更为常见（<0.001）。就临床病程而言，MG病情较为良性，大多数病例保持稳定（66.7%）。6例患者的mHY评分恶化；随访结束时只有1例患者需要依赖轮椅。至少在我们的研究中，这种不均衡的进展可能表明MG和PD可以独立发展。
临床医生应警惕PD和MG的关联，因为早期诊断和治疗至关重要。
