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Chin Med J (Taipei) 1996;58:62-5.
1Department of Neurology, Veterans Hospital-Chia Yi; 2Neurological Institute, Veterans General Hospital-Taipei, and Department of Neurology, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
A 55-year-old woman with a several-decade history of thyroid goiter is presented here as a case of myasthenia gravis complicated with hyperthyroidism and thymoma with serological evidence of systemic lupus erythematosus (SLE). She had had right eyelid ptosis since July 1992, with a positive tensilon test. The acetylcholine receptor antibody titer was 4.01 nmol/L. A thyroid function test revealed T3: 162 ng/dl, T4: 14.98 micron g/dl, TSH: 0.09 micron IU/ml and positive anti-microsomal antibody (1:400). An MRI of the chest showed a thymoma in the left thymus. Other autoantibody screenings include ANA (1:320, speckled pattern) and anti-ds DNA (+) suggesting a serological association with SLE. After three courses of plasmapheresis, she received an extended maximal thymomectomy and a subtotal thyroidectomy. She was then treated with prednisolone, Mestinon, Eltroxin and discharged without complications. The coexistence of myasthenia gravis, hyperthyroidism, thymoma and a serological evidence of SLE have not previously been documented in the literature.
[Chin Med J (Taipei) 1996;58:62-5.]
Keywords: hyperthyroidism, myasthenia gravis, systemic lupus erythematosus, thymoma
Received: November 28, 1995.
Accepted: February 24, 1996.
Address reprint requests to:
Ko-Pei Kao, MD
Neurological Institute
Veterans General Hospital-Taipei
No. 201, Sec. 2, Shih-Pai Road
Taipei, Taiwan, R.O.C.
Copyright: 1996, Chinese Medical Association (Taipei)