Journal of Neurological Sciences (Turkish) 2017 , Vol 34 , Num 1
Ocular Myasthenia Gravis and Alopecia Universalis
1Adnan Menderes University, Medical Faculty, Department of Neurology and Clinical Neurophysiology, Aydin, Turkey Alopecia areata and myasthenia gravis are two autoimmune diseases that are rarely associated with each other. We present a man aged 47 years who was newly diagnosed as having ocular myasthenia gravis but also had alopecia universalis, which started 15 years ago. His findings of negative decrement response, increased jitter values of the orbicularis oculi muscle in single fiber analysis, negative anti-acetylcholine receptor antibody test, and negative thorax computerized tomography scan for thymoma were all compatible with ocular myasthenia gravis. Pyridostigmine 60 mg 4x1 and methylprednisolone 16 mg 1x1 were administered and relief of the symptoms was observed. At the end of the first month, the patient reported improvement related with body hairs including eyebrows and scalp hairs, which were re-growing. Alopecia areata has been defined as a non-motor symptom of thymoma-associated myasthenia gravis, and usually starts after myasthenia gravis. Different from the alopecia areata, the alopecia universalis seen in this case was not related with the thymoma and started long before the ocular myasthenia gravis. The immunosuppressive treatment (steroid) used for ocular myasthenia gravis was also helpful for alopecia universalis in this case. Keywords : Ocular myasthenia gravis, alopecia universalis, alopecia, thymoma, anti-acetylcholine receptor antibody, treatment