Journal
BMJ CASE REPORTS
Volume 15, Issue 1, Pages -Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/bcr-2021-248011
Keywords
haematology (incl blood transfusion); neurology
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An 81-year-old woman presented with symptoms suggestive of myasthenia gravis, but was found to also have a pelvic follicular lymphoma. After receiving radiotherapy and medication, her MG symptoms improved and the lymphoma went into remission, highlighting the importance of screening for other underlying conditions in MG patients.
An 81-year-old woman presented with neck weakness, dysarthria, dysphasia and left-sided ptosis. Myasthenia gravis (MG) was strongly suspected. Voltage gated calcium channel (VGCC) antibodies, associated with Lambert-Eaton myasthenic syndrome (LEMS), were negative. Acetylcholine receptor (AChR) antibody level was 536 nmol/L and diagnosis of MG was confirmed. Imaging revealed a pelvic mass and subsequent biopsy confirmed a pelvic follicular lymphoma. Our searches revealed this to be the first documented case of MG associated with a pelvic follicular lymphoma. She underwent radiotherapy to treat the lymphoma and received both pyridostigmine and immunosuppression to treat the MG. Her AChR antibody level decreased to 38 nmol/L and her MG symptoms resolved aside from head drop which is continuing to improve. Her lymphoma is now in remission. We have presented a case with a successful outcome, which highlights the importance of screening for lymphoma and thymoma in new presentations of MG.
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