title: Two patients with co-morbid myasthenia gravis in a Brazilian cohort of inflammatory bowel disease.
abstract: Co-morbid auto-immune disorders may affect 0.2% of the population. We present the clinical and electrodiagnostic findings of 2 patients with inflammatory bowel disease and myasthenia gravis from a Brazilian cohort of 218 inflammatory bowel disease patients. Patient 1: A 40year-old man was diagnosed with ulcerative colitis at age 37 and underwent total colectomy 3years later. After prednisone was tapered, he experienced a clinical relapse and was diagnosed with Crohn's disease. He then developed quadriparesis, bilateral ptosis, dysphagia and dysarthria. Patient 2: A 41year-old woman (diagnosed with ulcerative colitis and primary sclerosing cholangitis at age 35) developed speech impairment and ptosis. On both patients, symptoms quickly progressed over few weeks. Myasthenia gravis was diagnosed and confirmed by abnormal repetitive nerve stimulation and elevated anti-acetylcholine receptor antibody titers. Pyridostigmine and prednisone successfully treated both patients. Myasthenia gravis prevalence over 9years was 0.9%. Myasthenia gravis clinical course was not significantly modified by inflammatory bowel disease relapses and should be suspected with new onset weakness.
authors: Departamento de Medicina Clínica, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil. Electronic address: gondimfranc@gmail.com.
authors: Francisco de A A
authors: Fde A
authors: Gondim
authors: Departamento de Fisiologia e Farmacologia, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
authors: Gisele R
authors: GR
authors: de Oliveira
authors: Departamento de Medicina Clínica, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
authors: Davi F
authors: DF
authors: Araújo
authors: Departamento de Fisiologia e Farmacologia, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
authors: Marcellus Henrique Loiola Ponte
authors: MH
authors: Souza
authors: Departamento de Medicina Clínica, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
authors: Lúcia Libanez Bessa Campelo
authors: LL
authors: Braga
authors: Department of Neurology & Psychiatry, St. Louis University, St. Louis, MO, USA.
authors: Florian P
authors: FP
authors: Thomas
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000453:epidemiology; D008297:Male; D009157:Myasthenia Gravis / Q000150:complications* / Q000453:epidemiology
keywords: Auto-immune diseases; Crohn disease; Inflammatory bowel diseases; Myasthenia gravis; Ulcerative colitis