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Giant cell polymyositis associated with myasthenia gravis and thymoma
Institution:1. Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China;2. Department of Neurophysiology, Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China;3. Department of Neuropathology, Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China;4. Department of Thoracic Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, 241 W Huaihai Road, Shanghai, China;1. Department of Neurology and Neuroscience, Rutgers – New Jersey Medical School, 185 South Orange Avenue, MSB, H-506, Newark, NJ 07103, USA;2. Maharishi Markandeshwar University, Ambala 133207, India;1. Department of Neurosurgery, Hebei Medical University, Shijiazhuang, China;2. Department of Functional Neurosurgery, Hebei General Hospital, No. 348 Heping West Road, Shijiazhuang 050000, China;3. Department of Pathology, Hebei General Hospital, Shijiazhuang, China;1. Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;2. Department of Neurology, Minhang Hospital, Shanghai 201100, China;3. Department of Radiation Oncology, Albert Einstein College of Medicine of Yeshiva University, NY 10461, USA
Abstract:We report a case of a 40-year-old woman who developed generalized muscle weakness over a period of 2 months. Physical examination revealed palpable masses in her arms and hands. Serum creatine kinase levels were elevated. Electromyography showed myopathic changes and 3 Hz repetitive nerve stimulation revealed a decremental pattern on repetitive nerve stimulation. Muscle MRI demonstrated increased signal intensity in the biceps brachii on T1-weighted images. Chest CT scan showed a mediastinal mass suggestive of thymoma. Muscle biopsy revealed giant cell polymyositis. The patient was treated with cholinesterase inhibitors and corticosteroids with improvement of strength, and subsequently underwent thymectomy followed by radiotherapy.
Keywords:Giant cell polymyositis  Muscle MRI  Myasthenia gravis  Thymoma
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