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When polymyositis meets Graves' disease: A rare case report
S T Chai1, Y S Lim2, H N Achok2
1Hospital Sultanah Aminah, Department of Medicine, Johor Bahru, Johor, Malaysia. chaishuteng@gmail.com.
Graves' disease can rarely present with polymyositis, an inflammatory muscle disease. Prompt diagnosis and treatment with corticosteroids and immunosuppressants are crucial for managing this rare association.
Area of Science:
- Neurology
- Endocrinology
- Rheumatology
Background:
- Graves' disease, an autoimmune disorder, typically affects the thyroid gland.
- Polymyositis is an idiopathic inflammatory myopathy characterized by symmetrical proximal muscle weakness.
Observation:
- A young woman with Graves' disease presented with progressive proximal muscle weakness and elevated creatine kinase.
- Initial treatment for presumed thyrotoxic myopathy provided only transient improvement.
Findings:
- A subsequent relapse led to a diagnosis of polymyositis, confirmed by clinical, electrophysiological, and biochemical findings.
- The patient responded well to corticosteroids and azathioprine, indicating an autoimmune inflammatory myopathy.
Implications:
- This case highlights the importance of considering polymyositis in patients with Graves' disease experiencing unexplained myopathy.
- Early recognition and appropriate immunosuppressive therapy are essential for managing this rare co-occurrence.
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