Ocular myasthenia gravis presenting with Graves disease - a case report
Abstract
The coexistence of Graves disease and
myasthenia gravis - two distinct autoimmune
disorders directed against membrane
receptors TSH R and Ach R respectively
has been well documented.
We are reporting a case of Ossermans
grade I restricted ocular myasthenia gravis
presenting with Graves disease with
an aim to review literature on the optimal
management of these two coexisting disorders.
A 38 year old man presented with
ptosis about a year after the onset of
Graves disease. He was diagnosed to
have ocular myasthenia as he tested
positive for Ach R Ab. He was managed
with antithyroid drugs, cholinesterase inhibitors,
and steroid. After attaining
euthyroidism a total thyroidectomy with
extended trans-sternal thymectomy was
performed. He was relieved of his ocular
symptoms. Ptosis in a patient with
Graves disease should prompt one to
investigate for myasthenia gravis.
Surgery done for both the disorders at the
same sitting has a favourable outcome
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