PDF(Pubmed)
Abstract：
UNASSIGNED: The co-occurrence of myasthenia gravis (MG) and lichen planus (LP) is a rare phenomenon, with only 13 cases reported in the English literature between 1971 and 2024. Patients with MG or LP, regardless of the thymoma status, require close monitoring for other autoimmune diseases.
UNASSIGNED: Myasthenia gravis (MG) is an uncommon autoimmune disease, resulting in fatigable muscle weakness in the ocular, bulbar, and respiratory muscles, as well as muscles of the extremities. Lichen planus (LP) is an autoimmune mucocutaneous disease, presenting with pruritic and violaceous plaques on the skin and mucosal surfaces. So far, MG and LP co-occurrence is only reported in anecdotal individuals. This study reports a patient with MG and LP and systematically reviews the English literature on this rare co-occurrence from 1971 to 2024, indicating only 13 cases with similar conditions. A 67-year-old man presented with ocular and progressive bulbar symptoms, a year after being diagnosed with generalized LP. Laboratory evaluations were normal except for the high anti-AchR-Ab titer and a positive ANA titer. Neurologic examinations revealed asymmetric bilateral ptosis, weakness and fatigability in proximal muscles, and a severe reduction in the gag reflex. He was diagnosed with late-onset, seropositive MG. The treatment included pyridostigmine (60 mg, three times daily), intravenous immunoglobulin (25 g daily for 5 days), and oral prednisolone. There was no evidence of thymoma in the chest x-ray and CT scan without contrast. However, a CT scan with contrast was not performed due to the patient\'s unstable condition. A common autoimmune mechanism may underlie the unclear pathophysiology of MG and LP co-occurrence, with or without thymoma. Patients with MG, LP, or thymoma require close monitoring and assessment for other possible autoimmune diseases.
UNASSIGNED: Myasthenia gravis (MG) is an uncommon autoimmune disease, resulting in fatigable muscle weakness in the ocular, bulbar, and respiratory muscles, as well as muscles of the extremities. Lichen planus (LP) is an autoimmune mucocutaneous disease, presenting with pruritic and violaceous plaques on the skin and mucosal surfaces. So far, MG and LP co-occurrence is only reported in anecdotal individuals. This study reports a patient with MG and LP and systematically reviews the English literature on this rare co-occurrence from 1971 to 2024, indicating only 13 cases with similar conditions. A 67-year-old man presented with ocular and progressive bulbar symptoms, a year after being diagnosed with generalized LP. Laboratory evaluations were normal except for the high anti-AchR-Ab titer and a positive ANA titer. Neurologic examinations revealed asymmetric bilateral ptosis, weakness and fatigability in proximal muscles, and a severe reduction in the gag reflex. He was diagnosed with late-onset, seropositive MG. The treatment included pyridostigmine (60 mg, three times daily), intravenous immunoglobulin (25 g daily for 5 days), and oral prednisolone. There was no evidence of thymoma in the chest x-ray and CT scan without contrast. However, a CT scan with contrast was not performed due to the patient\'s unstable condition. A common autoimmune mechanism may underlie the unclear pathophysiology of MG and LP co-occurrence, with or without thymoma. Patients with MG, LP, or thymoma require close monitoring and assessment for other possible autoimmune diseases.
摘要：
■重症肌无力（MG）和扁平苔藓（LP）的同时发生是一种罕见的现象，1971年至2024年之间，英文文献中仅报告了13例病例。MG或LP患者，不管胸腺瘤的状况如何,需要密切监测其他自身免疫性疾病。
■重症肌无力（MG）是一种罕见的自身免疫性疾病，导致眼睛疲劳的肌肉无力，球杆,和呼吸肌，以及四肢的肌肉。扁平苔藓（LP）是一种自身免疫性皮肤粘膜疾病，在皮肤和粘膜表面呈现瘙痒和紫罗兰色的斑块。到目前为止,仅在轶事个体中报道了MG和LP共现。这项研究报告了一名MG和LP患者，并系统地回顾了1971年至2024年有关这种罕见共现的英文文献，表明只有13例类似情况。一名67岁的男子出现眼部和进行性球症状，一年后被诊断为全身性LP。实验室评估是正常的，除了高抗AchR-Ab滴度和阳性ANA滴度。神经系统检查显示双侧不对称下垂，近端肌肉无力和易疲劳，呕吐反射严重减弱。他被诊断为迟发性,血清阳性MG。治疗包括吡啶斯的明(60毫克，每天三次)，静脉注射免疫球蛋白（每天25克，持续5天），和口服泼尼松龙。胸部X线和CT扫描无对比无胸腺瘤迹象。然而,由于患者的病情不稳定，未进行CT增强扫描。常见的自身免疫机制可能是MG和LP共现的病理生理学不清楚的基础，有或没有胸腺瘤。MG患者,LP,或胸腺瘤需要密切监测和评估其他可能的自身免疫性疾病。
■重症肌无力（MG）是一种罕见的自身免疫性疾病，导致眼睛疲劳的肌肉无力，球杆,和呼吸肌，以及四肢的肌肉。扁平苔藓（LP）是一种自身免疫性皮肤粘膜疾病，在皮肤和粘膜表面呈现瘙痒和紫罗兰色的斑块。到目前为止,仅在轶事个体中报道了MG和LP共现。这项研究报告了一名MG和LP患者，并系统地回顾了1971年至2024年有关这种罕见共现的英文文献，表明只有13例类似情况。一名67岁的男子出现眼部和进行性球症状，一年后被诊断为全身性LP。实验室评估是正常的，除了高抗AchR-Ab滴度和阳性ANA滴度。神经系统检查显示双侧不对称下垂，近端肌肉无力和易疲劳，呕吐反射严重减弱。他被诊断为迟发性,血清阳性MG。治疗包括吡啶斯的明(60毫克，每天三次)，静脉注射免疫球蛋白（每天25克，持续5天），和口服泼尼松龙。胸部X线和CT扫描无对比无胸腺瘤迹象。然而,由于患者的病情不稳定，未进行CT增强扫描。常见的自身免疫机制可能是MG和LP共现的病理生理学不清楚的基础，有或没有胸腺瘤。MG患者,LP,或胸腺瘤需要密切监测和评估其他可能的自身免疫性疾病。
