Myasthenia gravis, castleman disease, pemphigus, and anti-phospholipid syndrome

Introduction:

Myasthenia gravisis an autoimmune disease

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marked by neuromuscular transmission failure at the neuromuscular junction. Castleman disease is a rare lymphoproliferative disease characterized by non-cancerous angiofolicular hyperplasia of lymphatic tissue.

Methods and results:

We describe a young man with rapid, successive manifestations of myasthenia gravis, a solitary form of Castleman disease, pemphigus vulgaris, and anti-phospholipid syndrome, which resulted in 2 ischemic cerebrovascular events that caused a severe central neurological deficit.

Discussion:

We were unable to find a similar case in the literature, but we hypothesize that the temporal coincidence of these clinical entities may be related to a common immunological pathway, such as B-cell activation. Therefore, we treated the patient with an immunosuppressant and anticoagulant treatment, as well as rituximab, a monoclonal antibody therapy against CD20+.

full article at: http://onlinelibrary.wiley.com/doi/10.1002/mus.23657/abstract

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