title: [Familial myasthenia gravis: a case report in identical twins].
abstract: To the best of our knowledge this is the seventh case report of monozygotic twins both affected by myasthenia gravis (MG). The monozygotism was proven by sex identity, blood group and HLA determinations ('O' Rh+, A2, A19.2, B40, CW3). One paternal aunt was also affected and the three cases have high titles of anti-acetylcholine receptor antibodies and anti-striated muscle antibodies, which indicate an acquired form of MG. After several myasthenic crises the twins are now doing well with corticosteroid therapy. The paternal aunt has a more benign form of MG, with ocular and limb involvement (grade IIa of Osserman) and was submitted to thymectomy. The authors discuss the use of corticosteroid for the infantile form of MG instead of thymectomy, based on the immaturity of the immune system in the young age. The use of other immunosuppressive drugs is not advisable because of potential hazardous development of neoplasms.
authors.affiliation: Neurologista do Hospital de Base do Distrito Federal, Unidade de Pediatria, Brasília, Brasil.
authors.forename: E
authors.initials: E
authors.lastname: Dias-Tosta
authors.forename: M F
authors.initials: MF
authors.lastname: Aguiar
authors.forename: H
authors.initials: H
authors.lastname: Barbosa
authors.forename: S S
authors.initials: SS
authors.lastname: Vilela
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000032:analysis*; D004200:Diseases in Twins / Q000235:genetics*; D005260:Female; D015234:HLA-A Antigens / Q000032:analysis*; D006720:Homozygote; D006801:Humans; D007223:Infant; D009157:Myasthenia Gravis / Q000188:drug therapy / Q000235:genetics*; D010375:Pedigree; D011241:Prednisone / Q000627:therapeutic use; D011950:Receptors, Cholinergic / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D015234:HLA-A Antigens; D011950:Receptors, Cholinergic; D011241:Prednisone
vernacular_title: Miastenia grave familiar: relato de caso em gêmeas idênticas.