We report the association between myasthenia gravis and Graves disease in a 10-year-old boy and discuss the important aspects of both diseases, the importance of recognizing the association, and the investigations of choice to distinguish the 2 disorders. Early diagnosis of the 2 disorders may help in effective treatment institution with more rapid treatment responses with a possible improvement in prognosis and clinical course. Resolution of myasthenia gravis is not expected until the euthyroid state is restored. We recommend complete thyroid status review on all patients presenting with ocular myasthenia gravis.
Tanwani LK, Lohano V., Ewart R., et al. Myasthenia gravis in conjunction with Graves' disease: a diagnostic challenge. Endocr Pract. 2001;7:275-278.
2.
Marino M., Ricciardi R., Pinchera A., et al. Mild clinical expression of myasthenia gravis associated with autoimmune thyroid diseases. J Clin Endocrinol Metab. 1997;82:438-443.
3.
Lee KO, Guan R., Ee B., Cheah JSThyrotoxicosis, myasthenia gravis and periodic paralysis in a Chinese man . Postgrad Med J. 1985;61:49-50.
4.
Potagas C., Dellatolas G., Tavernarakis A., et al. Myasthenia gravis: changes observed in a 30-years retrospective clinical study of a hospital-based population. J Neurol. 2004;251: 116-117.
5.
Kitthaweesin K., Auvichayapat N., Panamonta O.Ocular myasthenia gravis and auto-immune thyroiditis in children. J Med Assoc Thai. 2005;88:S131-S133.
6.
Vincent A., Newsom-Davis J.Acethylcholine receptor antibody as a diagnostic test for myasthenia gravis: results in 153 validated cases and 2967 diagnostic assays. J Neurol Neurosurg Psychiatry. 1985;48:1246-1252.
7.
Scherbaum WA , Schumm F., Maisch B., et al. Myasthenia gravis: overlap with ``polyendocrine'' autoimmunity. Klin Wochenschr. 1983;61:509-515.
8.
Nishimura Y. , Oiso M., Fujisao S., et al. Peptide-based molecular analyses of HLA class II-associated susceptibility to autoimmune disease. Int Rev Immunol. 1998;17:229-262.
9.
Sekiguchi Y. , Hara Y., Takahashi M., Hirata Y.Reverse `see-saw' relationship between Graves' disease and myasthenia gravis; clinical and immunological studies. J Med Dent Sci. 2005;52: 43-50.
10.
Zelano G., Settesoldi D., Lino MM, Batocchi A., Evoli A., Tonali PAThymic disorders and myasthenia gravis: genetic aspects. Ann Med. 1999;31:46-51.
11.
Hohlfeld R. , Wekerle H.The thymus in mysathenia gravis. Neurol Clin. 1994;12:331-342.
12.
Kumar S.Management of ocular myasthenia gravis coexisting with thyroid ophthalmopathy . Neurol India. 2003;51:283-284.
