[A 46-year-old woman with myasthenia gravis associated with macromastia, erythroderma and hypogeusia].
A 46-year-old woman developed blepharoptosis, diplopia and hypogeusia in 1984, and was diagnosed as having myasthenia gravis and malignant thymoma. Her symptoms improved by thymectomy and oral prednisolone administration. In 1988 she complained of breast pain and swelling during menstruation. In 1990 her breast was enlarged to the size of an adult head, and she developed erythroderma and hypogeusia. She was admitted to Nagasaki University Hospital in August, 1990. On admission, erythema was seen in the whole body especially in the face, anterior chest, abdomen and the thigh. Her breast was the size of an adult head. Muscle strength was weak, and ocular movement was limited. She had blepharoptosis. Papillae of the tongue were atrophic. Endoclinological investigations revealed an elevation of PRL to 14.6 ng/ml (normal < 10), antibodies to the acetylcholine receptor to 118.0 nM (normal < 0.5). In TRH stimulation test the response of PRL was amplified. Four intrathoracic masses suspected of recurrence of malignant thymoma were seen in CT. Her macromastia depended upon the amount of PRL, and was reduced by bromocriptine. Erythroderma and hypogeusia were relieved by plasmaphersis. Therefore autoimmune mechanism may be related to these symptoms.
Sera
I
I
First Department of Internal Medicine, Nagasaki University School of Medicine.
Shibayama
K
K
Motomura
M
M
Tsujihata
M
M
Nagataki
S
S
D001940:Breast / Q000473:pathology*; D003873:Dermatitis, Exfoliative / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000150:complications*; D013651:Taste Disorders / Q000209:etiology*; D013945:Thymoma / Q000150:complications; D013953:Thymus Neoplasms / Q000150:complications