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Thursday, August 21, 2014
Could MG be a symptom of lupus?
Profile: Fit person leading a healthy lifestyle with exacerbations with slight amount of hives, sneezing, followed by pain in muscle, joints, head and loss of muscle control and uncontrollable eye movements, She has an elevated ANA, 4+ on all Allergy skin tests, no lesions in the brain or spinal column. Responds to "Tinsilon" for MG during exacerbations. Could MG be a conditional symptom of lupus?
Lupus and Myasthenia Gravis may coexist occasionally. In more than 70% of cases of such coexistence, MG precedes lupus. Rheumatoid arthritis can also occasionally coexist with lupus. There are certain features that help the physician diagnose lupus or other connective tissue diseases. Both lupus and MG are characterized by the presence of autoantibodies. ANAs are found in around 30% of MG patients without coexistent lupus. Like lupus, MG appears mainly in young adults, with female predominance. MG is characterized by neuromuscular fatigue and inability to sustain repeated muscular contractions. Lupus has many features: characteristic rashes, painful and swollen joints, mouth ulcers, hair loss, inflammation of the `sacs` around lungs and heart, inflammation of organs (kidney, brain, etc), decrease in blood cells in certain fashions. The case you present does not seem to have those features. A consult with a rheumatologist can be obtained to make the definitive diagnosis.
Yolanda Farhey, MD
College of Medicine
University of Cincinnati