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International Journal of Neurology and Neurosurgery

Volume  10, Issue 3, Jul-Sep 2018, Pages 277-279
 

Case Report

Myasthenia Gravis and Chronic Inflammatory Demyelinating Polyradiculoneuropathy in the Same Patient: A Clinical Rarity

Das Sumit1, Borah Tridip Jyoti2, Hussain Musharraf3, Dey Samarjit4

1Senior Resident 3Assistant Professor, Department of Neurolgy 2,4Assistant Professor, Department of Anaesthesiology & Critical Care, NEIGRIHMS, Shillong, Meghalaya 793012, India.

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DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.10318.23

Abstract

  We report a 23 year old female who concomitantly developed Chronic inflammatory polyradiculoneuropathy (CIDP) with Myasthenia gravis (MG). She initially presented with slowly progressing proximal and distal weakness in all four limbs with areflexia and elevated CSF protein. Electrophysiological studies confirmed the diagnosis of CIDP and started on corticosteroids and immunodulators. However, two months into treatment, her condition deterioted and she presented to emergency department with bilateral ptosis, breathing difficulty, dysphagia and no improvement in motor power. High titres of AchR antibodies, presence of ophthalmoplegia along with neostigmine test confirmed the concomitant diagnosis of MG with CIDP. Steroids along with acetylcholinesterase inhibitors were used to treat MG. Coexistence of two autoimmune disorders in the same patient can be a diagnostic labyrinth which can delay diagnosis and treatment. 

Keywords: Myasthenia Gravis; Chronic Inflammatory Demyelinating.


Corresponding Author : Borah Tridip Jyoti, Assistant Professor, Department of Anaesthesiology & Critical Care, NEIGRIHMS, Shillong, Meghalaya 793012, India.