[Graves ophthalmopathy and ocular myasthenia].

Abstract

BACKGROUND:

An 18-year-old woman presented with thyrotoxic symptoms - right sided lid retraction and exophthalmus. She complained of diplopia on lateral gaze. Laboratory investigations confirmed Grave's disease with hyperthyroidism and TSH receptor antibodies.

PATIENTS AND METHODS:

Her clinical symptoms improved after thyrostatic and steroid therapy. However, diplopia recurred 2 weeks after withdrawal of steroid therapy and a ptosis of the left lid appeared for the first time.

RESULTS:

A positive Tensilon test and electromyographic findings confirmed the diagnosis of myasthenia gravis with a predominantly ocular manifestation. Diplopia and ptosis improved with oral pyridostigmine.

CONCLUSIONS:

The coexistence of myasthenia gravis should be taken into consideration in the management of patients with Graves' ophthalmopathy.

• Authors: A Widjaja, J Rademaker, C Gölkel, A Holstein, E Leifke, N Wat
• Journal: Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft (Ophthalmologe) Vol. 97 Issue 1 Pg. 38-40 (Jan 2000) ISSN: 0941-293X [Print] Germany
• Vernacular Title: Basedow-Ophthalmopathie und okuläre Myasthenie.
• PMID: 10663788 (Publication Type: Case Reports, English Abstract, Journal Article)

Topics

• Adolescent
• Blepharoptosis (etiology)
• Diagnosis, Differential
• Diplopia (etiology)
• Female
• Graves Disease (complications, diagnosis)
• Humans
• Magnetic Resonance Imaging
• Myasthenia Gravis (complications, diagnosis)