title: Immune-mediated rippling muscle disease and myasthenia gravis.
abstract: Cases of acquired rippling muscle disease in association with myasthenia gravis have been reported. We present three patients with iRMD (immune-mediated rippling muscle disease) and AChR-antibody positive myasthenia gravis. None of them had thymus pathology. They presented exercise-induced muscle rippling combined with generalized myasthenia gravis. One of them had muscle biopsy showing a myopathic pattern and a patchy immunostaining with caveolin antibodies. They were successfully treated steroids and azathioprine. The immune nature of this association is supported by the response to immunotherapies and the positivity of AChR-antibodies.
authors.affiliation: Neuromuscular Diseases Section, Neurology Department, Italian Hospital of Buenos Aires, Argentina. Electronic address: mariela.bettini@hospitalitaliano.org.ar.
authors.forename: Mariela
authors.initials: M
authors.lastname: Bettini
authors.affiliation: Neuromuscular Diseases Section, Neurology Department, Italian Hospital of Buenos Aires, Argentina.
authors.forename: Hernan
authors.initials: H
authors.lastname: Gonorazky
authors.affiliation: Neuromuscular Diseases Section, Neurology Department, Italian Hospital of Buenos Aires, Argentina.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Chaves
authors.affiliation: Neurology Department, Cesar Milstein Care Unit, Buenos Aires, Argentina.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Fulgenzi
authors.affiliation: Neurology Department, San Roque Hospital, La Plata, Argentina.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Figueredo
authors.affiliation: Neuromuscular Diseases Section, Neurology Department, Italian Hospital of Buenos Aires, Argentina.
authors.forename: Silvia
authors.initials: S
authors.lastname: Christiansen
authors.affiliation: Neuromuscular Diseases Section, Neurology Department, Italian Hospital of Buenos Aires, Argentina.
authors.forename: Edgardo
authors.initials: E
authors.lastname: Cristiano
authors.affiliation: Unit of Neuromuscular and Neurodegenerative Disorder, Bambino Gesu' Children's Hospital, Rome, Italy.
authors.forename: Enrico S
authors.initials: ES
authors.lastname: Bertini
authors.affiliation: Neuromuscular Diseases Section, Neurology Department, Italian Hospital of Buenos Aires, Argentina.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Rugiero
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000150:complications / Q000175:diagnosis* / Q000276:immunology*; D009157:Myasthenia Gravis / Q000150:complications / Q000175:diagnosis* / Q000276:immunology*
keywords: AchR antibodies; Autoimmune; Caveolin; Myasthenia; Rippling