Myotonic dystrophy and multiple sclerosis

A 48-year-old man with myotonic dystrophy did well until the age of 37, when he developed the first of many remissions and exacerbations of multiple sclerosis. The only serum value done while the patient was infection free, revealed serum hypogammaglobulinemia. Three determinations of the relative concentration of gama globulin in the cerebrospinal fluid over 11 years, yielded markedly elevated levels. Previous work on the immunological abnormalities in both disease entities is discussed. This is the only published case in which these two diseases were manifested in the same patient.