Systemic lupus erythematosus-myasthenia gravis overlap syndrome: Presentation and treatment depend on prior thymectomy
In this study, we investigated four patients who met the diagnostic criteria for overlapping systemic lupus erythematosus (SLE) and myasthenia gravis (MG) but responded differently to treatment. All patients were acetylcholine receptor (AChR) and antinuclear antibody positive at the time of SLE diag...
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| Published in | Clinical immunology (Orlando, Fla.) Vol. 194; pp. 100 - 104 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.09.2018
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1521-6616 1521-7035 1521-7035 |
| DOI | 10.1016/j.clim.2018.07.007 |
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| Abstract | In this study, we investigated four patients who met the diagnostic criteria for overlapping systemic lupus erythematosus (SLE) and myasthenia gravis (MG) but responded differently to treatment. All patients were acetylcholine receptor (AChR) and antinuclear antibody positive at the time of SLE diagnosis. Two patients presented with SLE who have been effectively treated with cholinesterase inhibitors for MG. These patients developed SLE with photosensitivity, rash, and arthritis post thymectomy, which had been performed 29 years and 40 years earlier, respectively. Two other patients were found to have AChR antibodies and MG in the context on new-onset SLE. These subjects were responsive to hydroxychloroquine and immunosuppression but failed cholinesterase inhibitors. The evolution of these cases is relevant for the role of thymus in lupus pathogenesis during aging and for treatment selection in SLE-MG overlap patients. |
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| AbstractList | In this study, we investigated four patients who met the diagnostic criteria for overlapping systemic lupus erythematosus (SLE) and myasthenia gravis (MG) but responded differently to treatment. All patients were acetylcholine receptor (AChR) and antinuclear antibody positive at the time of SLE diagnosis. Two patients presented with SLE who have been effectively treated with cholinesterase inhibitors for MG. These patients developed SLE with photosensitivity, rash, and arthritis post thymectomy, which had been performed 29 years and 40 years earlier, respectively. Two other patients were found to have AChR antibodies and MG in the context on new-onset SLE. These subjects were responsive to hydroxychloroquine and immunosuppression but failed cholinesterase inhibitors. The evolution of these cases is relevant for the role of thymus in lupus pathogenesis during aging and for treatment selection in SLE-MG overlap patients. In this study, we investigated four patients who met the diagnostic criteria for overlapping systemic lupus erythematosus (SLE) and myasthenia gravis (MG) but responded differently to treatment. All patients were acetylcholine receptor (AChR) and antinuclear antibody positive at the time of SLE diagnosis. Two patients presented with SLE who have been effectively treated with cholinesterase inhibitors for MG. These patients developed SLE with photosensitivity, rash, and arthritis post thymectomy, which had been performed 29 years and 40 years earlier, respectively. Two other patients were found to have AChR antibodies and MG in the context on new-onset SLE. These subjects were responsive to hydroxychloroquine and immunosuppression but failed cholinesterase inhibitors. The evolution of these cases is relevant for the role of thymus in lupus pathogenesis during aging and for treatment selection in SLE-MG overlap patients.In this study, we investigated four patients who met the diagnostic criteria for overlapping systemic lupus erythematosus (SLE) and myasthenia gravis (MG) but responded differently to treatment. All patients were acetylcholine receptor (AChR) and antinuclear antibody positive at the time of SLE diagnosis. Two patients presented with SLE who have been effectively treated with cholinesterase inhibitors for MG. These patients developed SLE with photosensitivity, rash, and arthritis post thymectomy, which had been performed 29 years and 40 years earlier, respectively. Two other patients were found to have AChR antibodies and MG in the context on new-onset SLE. These subjects were responsive to hydroxychloroquine and immunosuppression but failed cholinesterase inhibitors. The evolution of these cases is relevant for the role of thymus in lupus pathogenesis during aging and for treatment selection in SLE-MG overlap patients. |
| Author | Minchenberg, Scott Brian Oaks, Zachary Chaparala, Geeta Perl, Andras Banki, Katalin |
| AuthorAffiliation | 2 Division of Rheumatology, Departments of Pathology, State University of New York, Upstate Medical University, College of Medicine, Syracuse, New York, USA 1 Division of Rheumatology, Departments of Medicine, State University of New York, Upstate Medical University, College of Medicine, Syracuse, New York, USA |
| AuthorAffiliation_xml | – name: 2 Division of Rheumatology, Departments of Pathology, State University of New York, Upstate Medical University, College of Medicine, Syracuse, New York, USA – name: 1 Division of Rheumatology, Departments of Medicine, State University of New York, Upstate Medical University, College of Medicine, Syracuse, New York, USA |
| Author_xml | – sequence: 1 givenname: Scott Brian surname: Minchenberg fullname: Minchenberg, Scott Brian organization: Division of Rheumatology, Department of Medicine, State University of New York, Upstate Medical University, College of Medicine, Syracuse, New York, USA – sequence: 2 givenname: Geeta surname: Chaparala fullname: Chaparala, Geeta organization: Division of Rheumatology, Department of Medicine, State University of New York, Upstate Medical University, College of Medicine, Syracuse, New York, USA – sequence: 3 givenname: Zachary surname: Oaks fullname: Oaks, Zachary organization: Division of Rheumatology, Department of Medicine, State University of New York, Upstate Medical University, College of Medicine, Syracuse, New York, USA – sequence: 4 givenname: Katalin surname: Banki fullname: Banki, Katalin organization: Department of Pathology, State University of New York, Upstate Medical University, College of Medicine, Syracuse, New York, USA – sequence: 5 givenname: Andras surname: Perl fullname: Perl, Andras email: perla@upstate.edu organization: Division of Rheumatology, Department of Medicine, State University of New York, Upstate Medical University, College of Medicine, Syracuse, New York, USA |
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| CitedBy_id | crossref_primary_10_1016_j_clim_2023_109810 crossref_primary_10_1016_j_nrl_2020_08_012 crossref_primary_10_1136_bcr_2019_231239 crossref_primary_10_1016_j_nrleng_2020_08_017 crossref_primary_10_1177_20587392211066424 crossref_primary_10_7759_cureus_14719 crossref_primary_10_1016_j_jaci_2020_02_028 crossref_primary_10_1007_s00296_021_04976_3 crossref_primary_10_7759_cureus_43725 crossref_primary_10_3389_fimmu_2023_1223322 crossref_primary_10_1155_2023_8939083 |
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| SubjectTerms | Acetylcholine receptor antibody Antinuclear antibody Antiphospholipid antibody Female Humans Lupus Erythematosus, Systemic - diagnosis Male Middle Aged Myasthenia gravis Myasthenia Gravis - diagnosis Systemic lupus erythematosus Thymectomy Thymectomy - methods Undifferentiated Connective Tissue Diseases - diagnosis |
| Title | Systemic lupus erythematosus-myasthenia gravis overlap syndrome: Presentation and treatment depend on prior thymectomy |
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