Myasthenia Gravis with Membranous Nephropathy, Successfully Treated with Extended Total Thymectomy

• Published in: Internal Medicine Vol. 39; no. 6; pp. 490 - 494
• Main Authors: MATSUDA, Masayuki, MIKI, Jun, TABATA, Ken-ichi, IKEZOE, Masaya, NISHIZAWA, Nobuhiro, ISHIGAME, Hiroki
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 2000; Japanese Society of Internal Medicine
• Subjects: anti-acetylcholine receptor antibody; Biological and medical sciences; Female; Glomerulonephritis; Glomerulonephritis, Membranous - complications; Glomerulonephritis, Membranous - surgery; hepatitis B virus carrier; Humans; Medical sciences; Middle Aged; Myasthenia Gravis - complications; Myasthenia Gravis - surgery; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Remission Induction; renal biopsy; Thymectomy - methods; Kidney disease; Human; Neuromuscular diseases; Nervous system diseases; Urinary system disease; Treatment efficiency; Case study; Concomitant disease; Myasthenia gravis; Thymectomy; Treatment; Surgery; Membranous glomerulonephritis
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.39.490

A 46-year-old woman showed proteinuria and hematuria after left blepharoptosis, and revealed a histopathology of membranous nephropathy (MN) at renal biopsy. She was diagnosed as having myasthenia gravis (MG) because of a positive edrophonium test and anti-acetylcholine receptor (AchR) antibodies in serum. We found a decrease in anti-AchR antibodies after extended total thymectomy, in parallel with an improvement in both urinary findings and myasthenic symptoms. In this case, MG preceded MN and the thymectomy was effective for both diseases, suggesting that the thymus might play an important role in the pathogenesis of MN. (Internal Medicine 39: 490-494, 2000)