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A Case of Generalized Myasthenia Gravis with Membranous Nephropathy

Elkhatib M, Abdalla A* and Mahmoud H

We report a 43-year-old woman with bilateral partial ptosis, complete external ophthalmoplegia, and proximal limb weakness. She was found to have generalized myasthenia gravis and membranous nephropathy with normal renal functions. Her myasthenic symptoms and signs improved within 2 months on treatment with pyridostigmine.The occurrence of glomerulonephritis is usually not considered to possibly accompany the course of MG and therefore, myasthenia gravis with membranous nephropathy was considered a rare association Twenty-four other cases of nephrotic syndrome associated with thymoma and myasthenia gravis have been reported in the literature, many of them were having membranous nephropathy and thus we support the notion that this form of glomerulonephritis is among the most frequently associated with MG. Most reported cases were related to thymic abnormality or thymectomy. However, our patient was neither thymectomized nor having thymoma. It is postulated that either thymic hyperplasia- with normal sized thymus- or subclinical stage of a thymoma may be the underlying aetiological factor in this patient.