title: Anti-MuSK myasthenia gravis presenting with Epstein-Barr virus-associated mononucleosis and immune-mediated diabetes mellitus.
abstract: We report a young woman with the abrupt onset of infectious mononucleosis due to Epstein-Barr virus associated with a subsequent autoimmune form of diabetes mellitus and myasthenia gravis with anti-muscle-specific kinase (MuSK) antibodies. The simultaneous onset of these two autoimmune diseases preceded by a systemic viral illness supports a causal relationship between MuSK antibodies and myasthenia gravis and suggests the possibility of a viral trigger in some cases.
authors.affiliation: Department of Clinical Neurosciences, University of Calgary, 3330 Hospital Drive NW, HMRB Room 155, Calgary, Alberta T2N 4N1, Canada.
authors.forename: Arunee
authors.initials: A
authors.lastname: Bhibhatbhan
authors.forename: Gregory
authors.initials: G
authors.lastname: Kline
authors.forename: Angela
authors.initials: A
authors.lastname: Vincent
authors.forename: Cory
authors.initials: C
authors.lastname: Toth
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D003920:Diabetes Mellitus / Q000209:etiology* / Q000276:immunology / Q000821:virology; D005260:Female; D006801:Humans; D007244:Infectious Mononucleosis / Q000150:complications*; D009157:Myasthenia Gravis / Q000209:etiology* / Q000276:immunology; D020794:Receptor Protein-Tyrosine Kinases / Q000276:immunology*; D011950:Receptors, Cholinergic / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D011950:Receptors, Cholinergic; C095714:MUSK protein, human; D020794:Receptor Protein-Tyrosine Kinases