The co-occurrence of myasthenia gravis (MG) and multiple sclerosis (MS) is rare, and in all the described cases MS had a relapsing-remitting course and the diseases had a benign clinical evolution. We describe herewith a patient with primary progressive MS (PPMS) and generalized MG with severe clinical course. This is the first report on a case of PPMS associated to MG. Studies on the histology and pathogenesis show that neurodegeneration is predominant over inflammation in PPMS, even if cellular and humoral immune-mediated mechanisms are thought to maintain a crucial importance in the development and progression of this form of disease. In the present case, the detection of cerebrospinal fluid IgM oligoclonal bands support the hypothesis of a possible role of antibody-mediated immunity in PPMS and suggest that humoral immunity may take part in the concomitant development of both MS and MG.
Primary progressive multiple sclerosis and generalized myasthenia gravis: an uncommon association / Bigliardi, Guido; Mandrioli, Jessica; F., Valzania; Nichelli, Paolo Frigio; N., Casula; Simone, ANNA MARIA; P., Sola. - In: NEUROLOGICAL SCIENCES. - ISSN 1590-1874. - STAMPA. - 31:6(2010), pp. 833-836. [10.1007/s10072-010-0358-6]
Primary progressive multiple sclerosis and generalized myasthenia gravis: an uncommon association
BIGLIARDI, Guido;MANDRIOLI, Jessica;NICHELLI, Paolo Frigio;SIMONE, ANNA MARIA;
2010
Abstract
The co-occurrence of myasthenia gravis (MG) and multiple sclerosis (MS) is rare, and in all the described cases MS had a relapsing-remitting course and the diseases had a benign clinical evolution. We describe herewith a patient with primary progressive MS (PPMS) and generalized MG with severe clinical course. This is the first report on a case of PPMS associated to MG. Studies on the histology and pathogenesis show that neurodegeneration is predominant over inflammation in PPMS, even if cellular and humoral immune-mediated mechanisms are thought to maintain a crucial importance in the development and progression of this form of disease. In the present case, the detection of cerebrospinal fluid IgM oligoclonal bands support the hypothesis of a possible role of antibody-mediated immunity in PPMS and suggest that humoral immunity may take part in the concomitant development of both MS and MG.
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