Abstract：
BACKGROUND: Patients with myasthenia gravis may also have comorbid autoimmune diseases. Since both myasthenia gravis and neuromyelitis optica spectrum disease are mediated by antibodies, they are likely to occur together. However, since multiple sclerosis is an autoimmune disease that is not mediated by a specific antibody, it has fewer immune mechanisms in common with myasthenia gravis than neuromyelitis optica spectrum disease. We encountered a case of newly developed multiple sclerosis in a patient with myasthenia gravis.
METHODS: A 46-year-old man was diagnosed with ocular myasthenia gravis 6 years ago and had been taking pyridostigmine to control his symptoms.
METHODS: The patient developed right optic neuritis, and multiple sclerosis was suspected based on the brain magnetic resonance imaging findings. However, the required diagnostic criteria were not met.
METHODS: Disease-modifying therapy was not initiated, and clinical progression of the disease was monitored.
RESULTS: One year after the onset of optic neuritis, the patient developed myelitis and was diagnosed with multiple sclerosis, prompting treatment with disease-modifying therapy.
CONCLUSIONS: When optic neuritis occurs in patients with myasthenia gravis, careful evaluation is necessary while considering the possibility that it may be the first symptom of a demyelinating central nervous system disease. Therefore, it is important to conduct shorter-interval monitoring and symptom screening for patients with neurological autoimmune diseases, such as myasthenia gravis, even if multiple sclerosis is not initially suspected, to achieve early detection of multiple sclerosis.
METHODS: A 46-year-old man was diagnosed with ocular myasthenia gravis 6 years ago and had been taking pyridostigmine to control his symptoms.
METHODS: The patient developed right optic neuritis, and multiple sclerosis was suspected based on the brain magnetic resonance imaging findings. However, the required diagnostic criteria were not met.
METHODS: Disease-modifying therapy was not initiated, and clinical progression of the disease was monitored.
RESULTS: One year after the onset of optic neuritis, the patient developed myelitis and was diagnosed with multiple sclerosis, prompting treatment with disease-modifying therapy.
CONCLUSIONS: When optic neuritis occurs in patients with myasthenia gravis, careful evaluation is necessary while considering the possibility that it may be the first symptom of a demyelinating central nervous system disease. Therefore, it is important to conduct shorter-interval monitoring and symptom screening for patients with neurological autoimmune diseases, such as myasthenia gravis, even if multiple sclerosis is not initially suspected, to achieve early detection of multiple sclerosis.
摘要：
背景：重症肌无力患者也可能合并自身免疫性疾病。由于重症肌无力和视神经脊髓炎谱系疾病都是由抗体介导的，它们很可能一起发生。然而,由于多发性硬化症是一种自身免疫性疾病，不是由特异性抗体介导的，与视神经脊髓炎谱系疾病相比，它与重症肌无力共同的免疫机制较少。我们在重症肌无力患者中遇到了一例新发展的多发性硬化症。
方法：一名46岁的男性在6年前被诊断出患有眼部重症肌无力，并一直在服用吡啶斯的明以控制其症状。
方法：患者出现右侧视神经炎，根据脑部磁共振成像结果怀疑多发性硬化症。然而,未达到所需的诊断标准.
方法：未开始疾病改善治疗，并监测疾病的临床进展。
结果：视神经炎发病后一年，患者出现脊髓炎并被诊断为多发性硬化症,提示用疾病修饰疗法治疗。
结论：重症肌无力患者发生视神经炎时，仔细评估是必要的，同时考虑它可能是脱髓鞘中枢神经系统疾病的首发症状。因此,对神经系统自身免疫性疾病患者进行较短间隔的监测和症状筛查非常重要，比如重症肌无力,即使最初没有怀疑多发性硬化症，以实现多发性硬化症的早期检测。
方法：一名46岁的男性在6年前被诊断出患有眼部重症肌无力，并一直在服用吡啶斯的明以控制其症状。
方法：患者出现右侧视神经炎，根据脑部磁共振成像结果怀疑多发性硬化症。然而,未达到所需的诊断标准.
方法：未开始疾病改善治疗，并监测疾病的临床进展。
结果：视神经炎发病后一年，患者出现脊髓炎并被诊断为多发性硬化症,提示用疾病修饰疗法治疗。
结论：重症肌无力患者发生视神经炎时，仔细评估是必要的，同时考虑它可能是脱髓鞘中枢神经系统疾病的首发症状。因此,对神经系统自身免疫性疾病患者进行较短间隔的监测和症状筛查非常重要，比如重症肌无力,即使最初没有怀疑多发性硬化症，以实现多发性硬化症的早期检测。
