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February 1969

Familial Mya sthenia Gravis: Report of a Case in Identical Twins and Review of Family Aggregates

Author Affiliations

USNR, Portsmouth, Va
From the United States Naval Hospital, Ports-mouth, Va. Dr. Herman is now a fellow in neurology at the University of Virginia Hospital, Charlottesville, Va.

Arch Neurol. 1969;20(2):140-146. doi:10.1001/archneur.1969.00480080040004

AS EARLY as 1937, Rothbart1 suggested that myasthenia gravis was genetically determined. Sixty-two additional familial cases have since been recorded, yet no clear-cut pattern of inheritance has emerged and no satisfactory explanation has been offered.

Recently, familial aggregates of autoimmune disease have been noted and, coincidentally, the concept of myasthenia gravis as an autoimmune disease has been advanced. In this communication, two cases of myasthenia gravis in monozygotic twins are reported; the literature concerning familial myasthenia is reviewed, and an hypothesis combining immunologic and genetic data is offered in explanation.

Report of Cases  CASE 1.—The patient (Fig 1) was the second born of twin girls. Her mother was 24 at the time of confinement. An abruptio placentae occurred in the 33rd week of gestation and precipitated labor. An umbilical hernia was the only abnormality noted at birth. Examination of the placental membranes revealed only one chorion.The infant

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