Abstract
AbstractNeuromyelitis optica (NMO) and myasthenia gravis are antibody‐mediated diseases that frequently occur in patients with other autoimmune systemic or organ‐specific diseases. We report the case of a Portuguese woman diagnosed with generalized myasthenia gravis in her mid 20s, and who remained symptom‐free after undergoing thymectomy. Approximately 40 years later, at the age of 74 years, the patient presented with recurrent episodes of longitudinally extensive transverse myelitis within a period of 4 months. The work‐up showed positive antibodies to aquaporin‐4, and a NMO spectrum disorder was diagnosed. Under treatment with high‐dose oral corticosteroids and azathioprine, there were no further relapses. As far as we know, this is one of the longest latency periods reported between the two diagnoses, highlighting that NMO should be kept in mind in any patient with myasthenia gravis developing central nervous system signs and/or loss of visual acuity.
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