Myasthenia gravis and polymyositis as manifestations of chronic graft-versus-host-disease.
Myasthenia gravis and polymyositis are each a rare manifestation of immune dysregulation in chronic graft-versus-host disease (cGVHD). We report a 4-year-old boy with idiopathic acquired aplastic anemia who developed myasthenia gravis 22 months and polymyositis 69 months after an allogeneic BMT (5/6 matched, MLC-nonreactive). The occurrence of both syndromes in one patient is unique. Autoimmune dysfunction may be associated with the development of cGVHD as demonstrated by the high incidence of prior aplastic anemia in BMT patients presenting with myasthenia gravis and polymyositis. Recognition of these neurologic manifestations is important in the diagnosis and treatment of cGVHD.
Tse
S
S
Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
Saunders
E F
EF
Silverman
E
E
Vajsar
J
J
Becker
L
L
Meaney
B
B
D000741:Anemia, Aplastic / Q000628:therapy; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002675:Child, Preschool; D002908:Chronic Disease; D006086:Graft vs Host Disease / Q000150:complications*; D006801:Humans; D008297:Male; D009157:Myasthenia Gravis / Q000209:etiology*; D017285:Polymyositis / Q000209:etiology*; D014184:Transplantation, Homologous