Kamabu Larrey Kasereka, Oboth Ronald, Kataka Louange Maha, Baruani Albert Yemba, Lekuya Hervé Monka, Kangitsi Charles Kahindo
Faculty of Medicine, Neurosurgery Division, Catholic University of Graben, P.O. Box 29, Butembo, Democratic Republic of the Congo.
Department of Surgery, Neurosurgery, College of Medicine, Makerere University, Kampala, Uganda.
J Med Case Rep. 2025 Jul 29;19(1):375. doi: 10.1186/s13256-025-05198-y.
Myasthenia gravis is a neuromuscular autoimmune condition characterized by the presence of antibodies against acetylcholine receptors. It may present as a generalized disorder or remain limited to specific muscle groups. Myasthenia gravis can occur independently or alongside other autoimmune conditions, including Hashimoto's thyroiditis and Graves' disease. Although the co-occurrence of these disorders is recognized, it is an extremely rare clinical phenomenon.
A 20-year-old woman of Muganda ethnicity, with a 2-year history of Graves' disease confirmed by thyroid scintigraphy, developed a myasthenic syndrome leading to acute respiratory failure. Her condition improved with the administration of Prostigmine. Further investigations, including electrophysiological studies and immunological tests, confirmed a diagnosis of myasthenia gravis. The patient demonstrated a positive response to medical therapy.
This case highlights the importance of recognizing the rare association between myasthenia gravis and Graves' disease. Accurate diagnosis and effective treatment require a coordinated, multidisciplinary approach, particularly given the challenges posed by overlapping symptoms and the exacerbating effects of hyperthyroidism on myasthenia gravis.
重症肌无力是一种神经肌肉自身免疫性疾病，其特征是存在抗乙酰胆碱受体抗体。它可能表现为全身性疾病，也可能局限于特定肌肉群。重症肌无力可独立发生，也可与其他自身免疫性疾病同时出现，包括桥本甲状腺炎和格雷夫斯病。尽管这些疾病的共现已得到认可，但这是一种极其罕见的临床现象。
一名20岁的穆干达族女性，经甲状腺闪烁扫描确诊患有格雷夫斯病2年，出现了导致急性呼吸衰竭的重症肌无力综合征。使用新斯的明治疗后病情好转。进一步检查，包括电生理研究和免疫学检测，确诊为重症肌无力。该患者对药物治疗表现出积极反应。
本病例凸显了认识重症肌无力与格雷夫斯病之间罕见关联的重要性。准确的诊断和有效的治疗需要一种协调的多学科方法，特别是考虑到重叠症状带来的挑战以及甲状腺功能亢进对重症肌无力的加重作用。
