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A case of Mu SK myasthenia gravis associated with solitary lymphadenopathy and insidious autoimmune‐like diffuse encephalopathy
Author(s) -
Konishi Tetsuro,
Kohsaka Masayuki,
Daifu Masako
Publication year - 2019
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.12283
Subject(s) - medicine , pathology , myasthenia gravis , encephalopathy , gliosis , infiltration (hvac) , hyperplasia , generalized lymphadenopathy , lymphoma , physics , thermodynamics
We report an 81‐year‐old woman with anti‐muscle‐specific kinase (Mu SK ) antibody‐positive myasthenia gravis ( MG ) associated with solitary lymphadenopathy and insidious encephalopathy. At the age of 74, her myasthenic symptoms were remitted by immunosuppressive therapy and solitary abdominal lymphadenopathy was removed from the mesentery. Histopathological examinations showed follicular hyperplasia with marked IgG4‐positive plasma cell infiltration in the interfollicular connective tissues. Simultaneous head MRI examinations revealed diffuse brain lesions predominantly in the white matter without any neurological symptoms. The biopsied brain specimen showed scattered lymphocyte infiltration around vessels and reactive gliosis without IgG4‐positive plasma cells suggesting an autoimmune‐like encephalopathy. At the age of 81, Mu SK ‐ MG was remittent, but the head MRI abnormalities sustained.