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Immune-mediated rippling muscle disease and myasthenia gravis
Mariela Bettini1, Hernan Gonorazky1, Marcelo Chaves1
1Neuromuscular Diseases Section, Neurology Department, Italian Hospital of Buenos Aires, Argentina.
Abstract:
Cases of acquired rippling muscle disease in association with myasthenia gravis have been reported. We present three patients with iRMD (immune-mediated rippling muscle disease) and AChR-antibody positive myasthenia gravis. None of them had thymus pathology. They presented exercise-induced muscle rippling combined with generalized myasthenia gravis. One of them had muscle biopsy showing a myopathic pattern and a patchy immunostaining with caveolin antibodies. They were successfully treated steroids and azathioprine. The immune nature of this association is supported by the response to immunotherapies and the positivity of AChR-antibodies.
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