A Case of myasthenia gavis associated with alopecia areata

Abstract

: Myasthenia gravis (MG) is an autoimmune disease that is associated with antibodies to acetylcholine receptors. It is associated with other autoimmune diseases. alopecia areata is characterized by the sudden appearance of a round or oval patch of non-scarring and painless hair loss with spontaneous remissions and exacerbations. It is also known that immune factors may play an important role in the pathogenesis of alopecia areata. Alopecia areata has been reported to coincide with MG, particularly with thymoma. But MG with alopecia areata is rare in the case of without thymoma. Case : A 17-year-old woman presented with slowly progressed bilateral ptosis and motor paralysis after repetitive movement. Ocular movement was full. Multiple incomplete circles of alopecia were noted over hair and eyebrows. The anti-acetylcholine receptor antibody concentration was positive (21nMol/L). The Tensilon test was positive to an improvement ptosis and electrophysiologic studies showed a decremental response (12%). The thyroid function test was normal. On computed tomography of the chest, thymoma is not detected. Seven months before diagnosed with MG, her hair and eyebrows had began to disappear. Alopecia areata was diagnosed on the basis of skin biopsy. After treatment with cholinesterase inhibitors, ptosis and motor paralysis are improved. But alopecia areata is more aggravated.