Myasthenia gravis and Polymyositis presented simultaneously

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Florentina Berianu

Mayo Clinic Florida, USA

: J Spine Neurosurg

Abstract

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Background: Myasthenia gravis (MG) and Polymyositis (PM) has been found to be present simultaneously. Objectives: To present two new cases seen in our clinic with concomitant onset of MG and PM. Methods: We reviewed the electronic medical records of the patients diagnosed with MG and PM. Results: Two male patients, 50 and 66 year-old presented to our clinic with significant muscle weakness. Both patients had described dysphagia for solids and liquids and neck weakness. Muscle enzymes were highly elevated in both and EMG showed myopathic features. Patient has limited improvement with pulse therapy with steroids and on further interview we learned that one patient had experienced fatigable muscle weakness involving proximal as well as distal muscle and the other one had experienced diplopia. These features are more typical for MG and the specialized EMG testing were suggestive of MG along with positive anti-ACh antibodies. The muscle biopsy was supportive of polymyositis. Fortunately the patients responded to Prednisone 1 mg /kg, IVIG and acetylcholinesterase inhibitors. Conclusion: There are more than 20 cases described in the literature of simultaneous presentation of MG and PM. Physician should consider this possibility when patients have atypical presentation for PM with distal weakness, muscular fatigability, diplopia and dysphagia or do not respond well to pulse doses steroids. Specialized EMG helps with the diagnosis

Biography

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