Abstract
The co-occurrence of myasthenia gravis (MG) and Guillain Barré syndrome (GBS) is uncommon
with a few reported cases in the literature. There is only one reported case of MG
and Miller Fisher variant of GBS. We described an 84 year old Chinese woman with underlying
seropositive myasthenia gravis (MG) who presented with ophthalmoplegia, areflexia
and acute neuromuscular weakness. She was proved to have co-occurrence of MG and GBS/Miller
Fisher overlap syndrome with positive anti-GQ1b antibody. The unusual finding in this
patient raises an interesting question on their pathogenesis with the possibility
that prior activation of the immune system may predispose the development of autoantibodies
against other antigens within the same set of muscles.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Neurological SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Myasthenia gravis: clinical, immunological and therapeutic advances.Acta Neurol Scand. 2005; 111: 134-141
- Acetylcholine receptor antibody as a diagnostic test for myasthenia gravis: result in 153 validated cases and 2967 diagnostic assays.J Neurol Neurosurg Psychiatry. 1985; 48: 1246-1252
- Anti-GQIb IgG-negative case of overlapping Fisher's and Guillain–Barre syndrome after Campylobacter jejuni (PEN 19) enteritis.Clin Neurol. 2001; 41: 801-804
- Structure of Campylobacter jejuni lipopolysaccharides determines anti-ganglioside specificity and clinical features Guillain–Barre and Miller Fisher patients.Infect Immun. 2002; 70: 1202-1208
- Guillain–Barre syndrome.Lancet. 1998; 352: 635-641
- Anti-GQ1b IgG antibody syndrome: clinical and immunological range.J Neurol Neurosurg Psychiatry. 2001; 70: 50-55
- Polyradiculoneuritis and myasthenia gravis.Nouv Presse Med. 1981; 10: 253-254
- Acute polyneuropathy combined with myasthenia gravis.Acta Neurol Scand. 1982; 65: 681-682
- Myasthenia gravis and recurrent Guillain–Barre syndrome.Neurology. 1991; 41: 1848
- Acute motor sensory Guillain–Barre syndrome and myasthenia gravis.Eur J Intern Med. 2005; 16: 134-135
- Temporal coincidence between AMAN type of Guillain Barre syndrome and myasthenia gravis.J Neurol. 2007; 254: 264-265
- Myasthenia gravis and Guillain–Barre syndrome occurring simultaneously in the same patient.Muscle Nerve. 2008; : 544-546
- A case of ocular myasthenia gravis and Miller–Fisher syndrome.Hosp Med. 2005; 66: 116-117
- Neuromuscular junction dysfunction in Miller Fisher syndrome.Semin Ophthalmol. 2008; 23: 211-213
- Serum factor in Miller–Fisher variant of Guillain–Barré syndrome and neurotransmitter release.Lancet. Feb 19 1994; 343: 454-455
- Pre- and postsynaptic blockade of neuromuscular transmission by Miller–Fisher syndrome IgG at mouse motor nerve terminals.Eur J Neurosci. Jan 1998; 10: 281-290
- Miller Fisher anti-GQ1b antibodies: alpha-latrotoxin-like effects on motor end plates.Ann Neurol. 1999; 45: 189-199
- Intravenous immunoglobulin in neurological disease: a specialist review.J Neurol Neurosurg Psychiatry. 2002; 72: 440-448
- IgG from patients with Guillain–Barre syndrome interact with nicotinic acetylcholine receptor channels.Muscle Nerve. 2003; 27: 435-441
Article info
Publication history
Accepted:
August 19,
2008
Received in revised form:
August 16,
2008
Received:
July 11,
2008
Identification
Copyright
© 2008 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
