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Case Reports in Rheumatology
Volume 2013 (2013), Article ID 505686, 4 pages
http://dx.doi.org/10.1155/2013/505686
Case Report

Myasthenia Gravis and Stroke in the Setting of Giant Cell Arteritis

11st Department of Internal Medicine, Evangelismos General Hospital, Ypsilanti 45-47, 10676 Athens, Greece
29 Kosma Aitolou, Herakleio, 14121 Athens, Greece
3Department of Neurology, Evangelismos General Hospital, Ypsilanti 45-47, 10676 Athens, Greece
4Department of Rheumatology, Evangelismos General Hospital, Ypsilanti 45-47, 10676 Athens, Greece
5Department of Pathology, Evangelismos General Hospital, Ypsilanti 45-47, 10676 Athens, Greece

Received 11 April 2013; Accepted 4 May 2013

Academic Editors: H. Alexanderson, G. O. Littlejohn, and M. Salazar-Paramo

Copyright © 2013 Elli-Sophia Tripodaki et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This case report concerns the diagnosis of two independent chronic diseases in a patient hospitalized for stroke, myasthenia gravis (MG) and giant cell arteritis (GCA). MG has been found to be associated with several diseases, but there are very few cases documenting its coexistence with GCA. We report the case of a 79-year-old woman initially hospitalized for stroke. Patient’s concurrent symptoms of blepharoptosis, dysphagia, and proximal muscle weakness were strongly suggestive of myasthenia gravis. The persistent low-grade fever and elevated inflammatory markers in combination with the visual deterioration that developed also raised the suspicion of GCA. Histological examination confirmed GCA, while muscle acetylcholine receptor antibodies were also present. Even though in medicine one strives to interpret a patient’s symptoms with one diagnosis, when one entity cannot fully interpret the clinical and laboratory findings, clinicians must consider the possibility of a second coexisting illness.