Dermatomyositis and myastenia gravis: An uncommon association with therapeutic implications

Reumatol Clin. 2015 Jul-Aug;11(4):244-6. doi: 10.1016/j.reuma.2014.10.002. Epub 2014 Dec 12.
[Article in English, Spanish]

Abstract

The association of dermatomyositis with myasthenia gravis (MG) is uncommon, having been reported so far in only 26 cases. We report the case of a 69 year-old man diagnosed with MG two years ago and currently treated with piridostigmyne. The patient developed acute proximal weakness, shoulder pain and elevated creatine-kinase (CK). He also developed generalized facial erythema and Gottron's papules. Laboratory tests showed positive antinuclear and anti-Mi2 antibodies. Further analysis confirmed CK levels above 1000 U/l. The clinical management of the patient and the therapeutic implications derived from the coexistence of both entities are discusssed.

Keywords: Dermatomiositis; Dermatomyositis; Inflammatory miopathies; Miastenia gravis; Miopatías inflamatorias; Myasthenia gravis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cholinesterase Inhibitors / therapeutic use
  • Dermatomyositis / complications*
  • Dermatomyositis / diagnosis
  • Dermatomyositis / drug therapy
  • Drug Therapy, Combination
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Methotrexate / therapeutic use
  • Myasthenia Gravis / complications*
  • Myasthenia Gravis / drug therapy
  • Prednisone / therapeutic use
  • Pyridostigmine Bromide / therapeutic use

Substances

  • Cholinesterase Inhibitors
  • Immunosuppressive Agents
  • Pyridostigmine Bromide
  • Prednisone
  • Methotrexate