Immunosuppressive treatment of rippling muscles in patients with myasthenia gravis

Area of Science:

• Neurology
• Immunology

Background:

• Rippling muscle disease is a rare autosomal dominant disorder.
• It can also occur sporadically.

Observation:

• Two patients presented with rippling muscles followed by myasthenia gravis.
• One patient developed rippling muscles after Yersinia enterocolitica infection, followed by myasthenia gravis.
• The second patient had a history of asthma before rippling muscles and myasthenia gravis.

Findings:

• Both patients had positive acetylcholine receptor and anti-skeletal muscle antibody titers.
• Pyridostigmine treatment exacerbated rippling phenomena.
• Azathioprine treatment led to marked improvement in rippling muscle symptoms.

Implications:

• This suggests a potential autoimmune component in some cases of rippling muscle disease.
• Immunosuppressive therapy may be beneficial for managing rippling muscle disease.
• Further research is needed to understand the link between infections, autoimmune responses, and rippling muscle disease.