title: Myasthenia gravis, Castleman disease, pemphigus, and anti-phospholipid syndrome.
abstract: BACKGROUND
  Myasthenia gravis is an autoimmune disease marked by neuromuscular transmission failure at the neuromuscular junction. Castleman disease is a rare lymphoproliferative disease characterized by non-cancerous angiofolicular hyperplasia of lymphatic tissue.
  
  
  RESULTS
  We describe a young man with rapid, successive manifestations of myasthenia gravis, a solitary form of Castleman disease, pemphigus vulgaris, and anti-phospholipid syndrome, which resulted in 2 ischemic cerebrovascular events that caused a severe central neurological deficit.
  
  
  CONCLUSIONS
  We were unable to find a similar case in the literature, but we hypothesize that the temporal concidence of these clinical entities may be related to a common immunological pathway, such as B-cell activation. Therefore, we treated the patient with an immunosuppressant and anticoagulant treatment, as well as rituximab, a monoclonal antibody therapy against CD20+.
authors: Department of Neurology and Center of Clinical Neuroscience, Charles University Prague, First Faculty of Medicine and General University Hospital, Prague Kateřinská 30, 128 01 Praha 2, Czech Republic. michala.jakubikova@vfn.cz
authors: Michala
authors: M
authors: Jakubíková
authors: Jiří
authors: J
authors: Piťha
authors: Jan
authors: J
authors: Latta
authors: Edvard
authors: E
authors: Ehler
authors: Jan
authors: J
authors: Schutzner
mesh_terms: D000008:Abdominal Neoplasms / Q000473:pathology; D000328:Adult; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000473:pathology; D001763:Blepharoptosis / Q000209:etiology; D005871:Castleman Disease / Q000150:complications* / Q000473:pathology; D004172:Diplopia / Q000209:etiology; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D018908:Muscle Weakness / Q000209:etiology; D009157:Myasthenia Gravis / Q000150:complications* / Q000473:pathology; D009460:Neurologic Examination; D010392:Pemphigus / Q000150:complications* / Q000473:pathology; D020521:Stroke / Q000209:etiology; D014057:Tomography, X-Ray Computed