The coincidence of Guillain‐Barré syndrome and myasthenia gravis

Abstract

Background The occurrence of both Guillain-Barré syndrome (GBS) and Myasthenia Gravis (MG) conditions in the same individual is rare. The underlying pathophysiology was assumed to be an autoimmune humoral mechanism. A molecular mimicry in which a cross-reaction between autoantibodies and myelin sheath of peripheral nerves and acetylcholine receptors of the neuromuscular junction (NMJ) cannot be excluded as an underlying cause. Case presentation An 18-year-old female patient was examined. She was presented with symptoms of generalized weakness and distal weakness in both upper and lower extremities, more pronounced on the right side and with associated right foot drop and bilateral ptosis. The electrophysiological study was performed and the AChR antibody titre was determined. The patient was diagnosed with GBS and MG. Conclusions In conclusion, GBS and MG are two different neurological entities with different pathophysiology. New onset or persistence of symptoms in a patient with GBS treated with IVIG or plasmapheresis should probe for another autoimmune neurological illness, preferably autoimmune neuromuscular disorders like MG.