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November 22, 1965

Myasthenia Gravis and Rheumatoid Spondylitis: Coexistence in Three Cases

Author Affiliations

From the sections of medicine (Dr. Diessner) and neurology (Dr. Howard), Mayo Clinic and Mayo Foundation; and the Mayo Graduate School of Medicine, University of Minnesota (Dr. Carter), Rochester.

JAMA. 1965;194(8):913-914. doi:10.1001/jama.1965.03090210077028

RECENTLY, we observed a patient having myasthenia gravis and long-standing rheumatoid (ankylosing) spondylitis. The coexistence of these two relatively uncommon diseases was unusual in our experience, and a review of the English literature failed to reveal any previously reported cases. However, review of the case histories of the 857 patients having myasthenia gravis who were seen at the Mayo Clinic from 1934 to July 1964 yielded two other cases. These three cases are the subject of this report.

Report of Cases 

Case 1.—  A 55-year-old married white man, an electrician, entered the hospital on March 13, 1964, because of diplopia and ptosis of the upper eyelids. The diplopia had begun in September 1962, but it had not become severe until December 1963, when the ptosis began. Myasthenia gravis had been diagnosed, and the patient had responded well to treatment with pyridostigmine (Mestinon) bromide. However, in February 1964 his symptoms had

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