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Systemic sclerosis is an autoimmune disease characterized by progressive fibrosis of the skin and visceral organs. Myasthenia gravis is also an autoimmune disease characterized by weakness and fatigue of skeletal muscles. The symptoms of systemic sclerosis and myasthenia gravis overlap clinically, so the recognition of disease co-occurrence may be delayed. Co-occurrence of myasthenia gravis and systemic sclerosis is very uncommon and usually diagnosed after use of D-penicillamine for treating the systemic sclerosis. We report a case of a 49-year-old female patient who complained of general weakness and was diagnosed with myasthenia gravis. Four months earlier she was diagnosed with systemic sclerosis with Sjogren’s syndrome and her medications did not include D-penicillamine.

Co-occurrence of Myasthenia Gravis in a Patient with Systemic Sclerosis-Sjögren's Syndrome without D-penicillamine Therapy