Author/Editor		Hojs-Fabjan, Tanja; Žitnik, Lidija
Title		Miastenija gravis in avtoimuna tireopatija
Translated title		Myasthenia gravis and autoimmune thyroid disease
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 70, št. 12
Publication year		2001
Volume		str. 723-5
Language		slo
Abstract		Background. Myasthenia gravis is an autoimmune disease mediated by autoantibodies against the nicotinic acetylholin receptors at the neuromuscular junction. Patients with myasthenia gravis often have circulating antibodies against a variety of tissue constituents. Several studies have shown an increased occurrence of other autoimmune diseases. Patients and methods. The authors presented a patient with generalizired myasthenia gravis, which considerably weakened the oropharyngeal muscle and caused ocular palsies. At the same time the patient's autoimmune thyroid disease with hypotireosis was discovered. At first the patient reacted well to the therapy with pyridostigmin bromid and levotiroxin but after six months her clinical status worsened, what was mainly seen as oropharingeal muscle weakness, ocular palsies, ptosis and weakness of proximal arm muscles. The authors decided for the additional treatment with intravenous immunoglobulins and immunosupressive therapy. Conclusions. The authors described a case of the patient with myasthenia gravis and associated autoimmune thyroid disease with hypotireosis. It is generally known that autoimmune diseases can be associated with myasthenia gravis, which could trigger or worsen the disease. That is why we always have to think of a possibility of other associated autoimune diseases and broaden the diagnostic research.
Summary		Izhodišča. Miastenija gravis je avtoimunska bolezen, ki jo povzročijo protitelesa proti nikotinskim acetilholinskim receptorjem živčnomišičnega stika. Bolniki z miastenijo gravis imajo pogosto tudi cirkulirajoča protitelesa proti različnim tkivnim sestavinam, raziskave so pokazale povečano soprisotnost drugih avtoimunskih bolezni. Te lahko miastenijo sprožijo ali poslabšajo. Bolniki in metode. Avtorici opisujeta primer bolnice s sistemsko obliko miastenije gravis s pretežno prizadetostjo bulbarnega mišičja, mišic zrkel in dvigovalk vek. Sočasno sta ugotovili, da gre pri bolnici za avtoimunsko tireopatijo s hipotireozo. Bolnica se je najprej dobro odzvala na terapijo s piridostigmin bromidom in levotiroksinom, po šestih mesecih pa je prišlo do poslabšanja klinične slike, predvsem v smislu teže prizadetosti bulbarnega mišičja, mišic zrkel in dvigovalke desne veke ter oslabljene moči zgornjih udov. Odločili so se za dodatno imunosupresivno zdravljenje in zdravljenje z imunoglobulini. Zaključki. V prispevku sta avtorici prikazali primer bolnice z miastenijo gravis s pridruženo avtoimunsko tireopatijo s hipotireozo. Znano je, da so avtoimunske bolezni lahko pridružene miasteniji gravis, zato je ob postavitvi diagnoze miastenije gravis vedno treba pomisliti še na druge, pridružene avtoimunske bolezni in razširiti diagnostične preiskave.
Descriptors		MYASTHENIA GRAVIS THYROIDITIS, AUTOIMMUNE AGED