Ivan Martinka, Andrea Hergottová, Katarína Sitárová, Miriam Sosková, Peter Špalek
Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction caused by circulating antibodies that
interfere with the structures and functions of neuromuscular junction. Chronic inflammatory demyelinating polyneuropathy
(CIDP) is an immune-mediated polyradiculoneuropathy. In CIDP, the autoimmune cellular and humoral mechanisms
cause primary damage of the myelin sheath of peripheral nerves. In prolonged course of untreated CIDP secondary
axonal degeneration occurs.
In our work we present rare association of three autoimmune diseases in one patient: MG, CIDP, and autoimmune thyroiditis.
Because of combination of these diseases we have administered prednison, which is the first line treatment
both for CIDP and MG. At the same time we have administered acetylcholinesterase inhibitor and azathioprin as treatment
for generalized MG. We have achieved long – term pharmacological remission of MG with this treatment. CIDP
had also improved in the first months of therapy. But after lowering of prednison doses the exacerbation and progression
of CIDP had occured. Therefore we have started with chronic – intermittent therapy with intravenous immunoglobulin.
With this treatment we have achieved stabilization and improvement of clinical picture of CIDP.