Systemic lupus erythematosus-myasthenia gravis overlap syndrome: Presentation and treatment depend on prior thymectomy

Clinical Immunology : the Official Journal of the Clinical Immunology Society
Scott Brian MinchenbergAndras Perl

Abstract

In this study, we investigated four patients who met the diagnostic criteria for overlapping systemic lupus erythematosus (SLE) and myasthenia gravis (MG) but responded differently to treatment. All patients were acetylcholine receptor (AChR) and antinuclear antibody positive at the time of SLE diagnosis. Two patients presented with SLE who have been effectively treated with cholinesterase inhibitors for MG. These patients developed SLE with photosensitivity, rash, and arthritis post thymectomy, which had been performed 29 years and 40 years earlier, respectively. Two other patients were found to have AChR antibodies and MG in the context on new-onset SLE. These subjects were responsive to hydroxychloroquine and immunosuppression but failed cholinesterase inhibitors. The evolution of these cases is relevant for the role of thymus in lupus pathogenesis during aging and for treatment selection in SLE-MG overlap patients.

Citations

Aug 31, 2019·BMJ Case Reports·Jose Danilo B DiestroMa Epifania V Collantes
Aug 26, 2021·Rheumatology International·Alexandra KobzaCatherine Ivory
Oct 21, 2020·Neurología : publicación oficial de la Sociedad Española de Neurología·J Jiménez-AlonsoL Jáimez

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