Cushing's syndrome developing myasthenia gravis with takotsubo cardiomyopathy after adrenalectomy: a case report

BMC Neurol. 2024 Sep 20;24(1):355. doi: 10.1186/s12883-024-03866-y.

Abstract

Background: Several cases of autoimmune disease onset after treatment for Cushing's syndrome have been reported.

Case presentation: Herein, we report a case of myasthenia gravis crisis in a 51-year-old woman 2 months after adrenalectomy for adrenal Cushing's syndrome accompanied by takotsubo cardiomyopathy. The resolution of excessive endogenous cortisol after adrenalectomy may have triggered the onset of previously latent myasthenia gravis.

Conclusions: Observing the similarities in symptoms between myasthenia gravis and adrenal crisis, which can sometimes be challenging to differentiate, is essential. Moreover, the presence of takotsubo cardiomyopathy as a non-motor manifestation of myasthenic crisis must be noted.

Keywords: Autoimmune disease; Cortisol; Cushing’s syndrome; Myasthenia gravis; Takotsubo cardiomyopathy.

Publication types

  • Case Reports

MeSH terms

  • Adrenalectomy* / adverse effects
  • Cushing Syndrome* / complications
  • Cushing Syndrome* / etiology
  • Cushing Syndrome* / surgery
  • Female
  • Humans
  • Middle Aged
  • Myasthenia Gravis* / complications
  • Myasthenia Gravis* / diagnosis
  • Myasthenia Gravis* / surgery
  • Takotsubo Cardiomyopathy* / etiology