title: Immunosuppressive treatment of rippling muscles in patients with myasthenia gravis.
abstract: Rippling muscle disease is a rare autosomal dominant disorder that may occur sporadically. In this report two patients presenting with rippling muscles followed by myasthenia gravis are described. Our first patient developed rippling muscles about 1 month after infection with Yersinia enterocolitica. Two years later myasthenia gravis appeared. Our second patient had a 2-year history of asthma prior to the onset of rippling muscles which preceded the myasthenic symptoms by 4-8 weeks. Acetylcholine receptor and anti-skeletal muscle antibody titers were positive in both patients. In both patients the rippling phenomena worsened with pyridostigmine treatment but markedly improved after immunosuppression with azathioprine.
authors.affiliation: Friedrich-Baur Institute, Department of Neurology, Klinikum Innenstadt, University of Munich, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Müller-Felber
authors.forename: C F
authors.initials: CF
authors.lastname: Ansevin
authors.forename: K
authors.initials: K
authors.lastname: Ricker
authors.forename: A
authors.initials: A
authors.lastname: Müller-Jenssen
authors.forename: M
authors.initials: M
authors.lastname: Töpfer
authors.forename: H H
authors.initials: HH
authors.lastname: Goebel
authors.forename: D E
authors.initials: DE
authors.lastname: Pongratz
mesh_terms: D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D009135:Muscular Diseases / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D009157:Myasthenia Gravis / Q000150:complications* / Q000188:drug therapy; D010812:Physical Stimulation; D011729:Pyridostigmine Bromide / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D011729:Pyridostigmine Bromide; D001379:Azathioprine