October 1991

The Association of Pauciarticular Juvenile Arthritis and Myasthenia Gravis

Author Affiliations

From the Department of Pediatrics (Dr Glass), the Division of Padiatric Neurology, Department of Neurology (Dr Sher), and the Divisions of Pediatric Infectious Disease and Pulmonology, Department of Pediatrics (Dr Regelmann), University of Minnesota, Minneapolis; and the Departments of Immunology, Neurology, and Laboratory Medicine and Pathology Mayo Clinic, Rochester, Minn (Dr Lennon).

Am J Dis Child. 1991;145(10):1176-1180. doi:10.1001/archpedi.1991.02160100108033

• We encountered two children with fluorescent antinuclear antibody—positive pauciarticular juvenile arthritis who later developed myasthenia gravis. Acetylcholine receptor binding, blocking, and modulating antibodies, retrospectively tested on frozen serum, yielded negative results before the onset of myasthenic symptoms but all yielded strongly positive results coincident with the onset of weakness. In both children, myasthenia gravis responded to thymectomy, and one child had a beneficial response to plasmapheresis. Although, to our knowledge, only two patients with juvenile arthritis and myasthenia gravis have been described in the past, the presence of two additional children with both diseases in a single clinic population suggests that the association may be more prevalent than previously suspected.

(AJDC. 1991;145:1176-1180)