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Muscle Nerve. 2013 Mar;47(3):447-51. doi: 10.1002/mus.23657. Epub 2013 Feb 6.

Myasthenia gravis, Castleman disease, pemphigus, and anti-phospholipid syndrome.

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1
Department of Neurology and Center of Clinical Neuroscience, Charles University Prague, First Faculty of Medicine and General University Hospital, Prague Kateřinská 30, 128 01 Praha 2, Czech Republic. michala.jakubikova@vfn.cz

Abstract

INTRODUCTION:

Myasthenia gravis is an autoimmune disease marked by neuromuscular transmission failure at the neuromuscular junction. Castleman disease is a rare lymphoproliferative disease characterized by non-cancerous angiofolicular hyperplasia of lymphatic tissue.

METHODS AND RESULTS:

We describe a young man with rapid, successive manifestations of myasthenia gravis, a solitary form of Castleman disease, pemphigus vulgaris, and anti-phospholipid syndrome, which resulted in 2 ischemic cerebrovascular events that caused a severe central neurological deficit.

DISCUSSION:

We were unable to find a similar case in the literature, but we hypothesize that the temporal concidence of these clinical entities may be related to a common immunological pathway, such as B-cell activation. Therefore, we treated the patient with an immunosuppressant and anticoagulant treatment, as well as rituximab, a monoclonal antibody therapy against CD20+.

PMID:
23386221
DOI:
10.1002/mus.23657
[Indexed for MEDLINE]
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