A Patient with Fulminant Myasthenia Gravis Is Seropositive for Both AChR and LRP4 Antibodies, Complicated by Autoimmune Polyglandular Syndrome Type 3

This article describes the first reported case of myasthenia gravis (MG) seropositive for both acetylcholine receptor antibody and low-density lipoprotein receptor-related protein 4 antibody, complicated by autoimmune polyglandular syndrome (APS) type 3. The patient exhibited myasthenic weakness res...

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Autores principales: Inoue, Hiroyasu, Yamada, Kentaro, Fujii, Asami, Tomonari, Tatsuya, Mizuno, Kotaro, Mita, Keiko, Higuchi, Osamu, Akao, Masaya, Matsukawa, Noriyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2020
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516320/
https://www.ncbi.nlm.nih.gov/pubmed/32461531
http://dx.doi.org/10.2169/internalmedicine.4708-20
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author Inoue, Hiroyasu
Yamada, Kentaro
Fujii, Asami
Tomonari, Tatsuya
Mizuno, Kotaro
Mita, Keiko
Higuchi, Osamu
Akao, Masaya
Matsukawa, Noriyuki
author_facet Inoue, Hiroyasu
Yamada, Kentaro
Fujii, Asami
Tomonari, Tatsuya
Mizuno, Kotaro
Mita, Keiko
Higuchi, Osamu
Akao, Masaya
Matsukawa, Noriyuki
author_sort Inoue, Hiroyasu
collection PubMed
description This article describes the first reported case of myasthenia gravis (MG) seropositive for both acetylcholine receptor antibody and low-density lipoprotein receptor-related protein 4 antibody, complicated by autoimmune polyglandular syndrome (APS) type 3. The patient exhibited myasthenic weakness restricted to the ocular muscles and ptosis. Severe clinical deterioration ensued with predominant bulbar symptoms. MG rapidly worsened, the patient was intubated, and agranulocytosis due to thiamazole was also present, so it was necessary to perform thyroidectomy with tracheostomy and thymectomy in two phases. Both the double-seropositive MG and the APS were involved in the patient's rapid deterioration.
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spelling pubmed-75163202020-10-02 A Patient with Fulminant Myasthenia Gravis Is Seropositive for Both AChR and LRP4 Antibodies, Complicated by Autoimmune Polyglandular Syndrome Type 3 Inoue, Hiroyasu Yamada, Kentaro Fujii, Asami Tomonari, Tatsuya Mizuno, Kotaro Mita, Keiko Higuchi, Osamu Akao, Masaya Matsukawa, Noriyuki Intern Med Case Report This article describes the first reported case of myasthenia gravis (MG) seropositive for both acetylcholine receptor antibody and low-density lipoprotein receptor-related protein 4 antibody, complicated by autoimmune polyglandular syndrome (APS) type 3. The patient exhibited myasthenic weakness restricted to the ocular muscles and ptosis. Severe clinical deterioration ensued with predominant bulbar symptoms. MG rapidly worsened, the patient was intubated, and agranulocytosis due to thiamazole was also present, so it was necessary to perform thyroidectomy with tracheostomy and thymectomy in two phases. Both the double-seropositive MG and the APS were involved in the patient's rapid deterioration. The Japanese Society of Internal Medicine 2020-05-26 2020-09-01 /pmc/articles/PMC7516320/ /pubmed/32461531 http://dx.doi.org/10.2169/internalmedicine.4708-20 Text en Copyright © 2020 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Inoue, Hiroyasu
Yamada, Kentaro
Fujii, Asami
Tomonari, Tatsuya
Mizuno, Kotaro
Mita, Keiko
Higuchi, Osamu
Akao, Masaya
Matsukawa, Noriyuki
A Patient with Fulminant Myasthenia Gravis Is Seropositive for Both AChR and LRP4 Antibodies, Complicated by Autoimmune Polyglandular Syndrome Type 3
title A Patient with Fulminant Myasthenia Gravis Is Seropositive for Both AChR and LRP4 Antibodies, Complicated by Autoimmune Polyglandular Syndrome Type 3
title_full A Patient with Fulminant Myasthenia Gravis Is Seropositive for Both AChR and LRP4 Antibodies, Complicated by Autoimmune Polyglandular Syndrome Type 3
title_fullStr A Patient with Fulminant Myasthenia Gravis Is Seropositive for Both AChR and LRP4 Antibodies, Complicated by Autoimmune Polyglandular Syndrome Type 3
title_full_unstemmed A Patient with Fulminant Myasthenia Gravis Is Seropositive for Both AChR and LRP4 Antibodies, Complicated by Autoimmune Polyglandular Syndrome Type 3
title_short A Patient with Fulminant Myasthenia Gravis Is Seropositive for Both AChR and LRP4 Antibodies, Complicated by Autoimmune Polyglandular Syndrome Type 3
title_sort patient with fulminant myasthenia gravis is seropositive for both achr and lrp4 antibodies, complicated by autoimmune polyglandular syndrome type 3
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516320/
https://www.ncbi.nlm.nih.gov/pubmed/32461531
http://dx.doi.org/10.2169/internalmedicine.4708-20
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