Kawakita Kaiki, Saito Takuya, Kondo Yoshiyuki, Uchiyama Tsuyoshi, Sato Keishiro
Department of Neurology, Seirei Hamamatsu General Hospital, Hamamatsu, JPN.
Cureus. 2024 Dec 1;16(12):e74886. doi: 10.7759/cureus.74886. eCollection 2024 Dec.
Myasthenia gravis (MG) is characterized by weakness and rapid fatigue of voluntary muscles. Here, we present two cases of early-onset MG, complicated with M-proteinemia and demyelinating neuropathy. Case one was diagnosed with MG at age 29, received tacrolimus post-thymectomy, and developed M-proteinemia and demyelinating neuropathies at age 66 before being diagnosed with B-cell lymphoma. Case two was diagnosed with MG at age 21, received immunosuppressive drugs post-thymectomy, and was diagnosed with myelin-associated glycoprotein antibody-associated neuropathy at age 66. Demyelinating neuropathy with M-proteinuria should be considered when motor symptoms worsen in patients with early-onset MG who receive immunosuppressive drugs after thymectomy.
重症肌无力（MG）的特征是随意肌无力且迅速疲劳。在此，我们报告两例早发型MG病例，其合并有M蛋白血症和脱髓鞘性神经病。病例一在29岁时被诊断为MG，胸腺切除术后接受他克莫司治疗，66岁时在被诊断为B细胞淋巴瘤之前出现了M蛋白血症和脱髓鞘性神经病。病例二在21岁时被诊断为MG，胸腺切除术后接受免疫抑制药物治疗，66岁时被诊断为与髓鞘相关糖蛋白抗体相关的神经病。对于早发型MG患者，在胸腺切除术后接受免疫抑制药物治疗，若运动症状恶化，应考虑伴有M蛋白尿的脱髓鞘性神经病。
