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Muscle weakness in a girl with autoimmune hepatitis and Graves’ disease

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Abstract

Autoimmune hepatitis (AIH) is a chronic hepatic autoimmune disease of unknown etiology associated with inflammatory changes and autoantibodies. The combination of AIH, Grave’s disease, and myasthenia gravis (MG) is rare, with only one other case reported. We report a pediatric patient with AIH type 2 and Grave’s disease who developed MG whilst on a treatment with corticosteroids. A 13-year-old girl, diagnosed with thyrotoxicosis, was identified as having AIH type 2. During the course of her therapy, she developed muscle weakness. Investigations revealed increased anti-acetylcholine receptor (AChR) antibodies and her electromyopgraphy (EMG) was characteristic for MG. Her course is described here. This case highlights the importance of investigating muscle weakness in severely ill hospitalized patients.

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Abbreviations

AIH:

Autoimmune hepatitis

MG:

Myasthenia gravis

Anti-AchR:

Anti-acetylcholine receptor

EMG:

Electromyography

TSH:

Thyroid-stimulating antibody

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Authors and Affiliations

  1. Department of Pediatrics, McMaster University, Hamilton, ON, Canada

    Ahmed Sarkhy & Mark Tarnopolsky

  2. Department of Pediatrics, University of Alberta, Rm 9219 Aberhart Center #1, 11402 University Ave. NW, Edmonton, AB, T6G 2J3, Canada

    Rabindranath Persad

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  1. Ahmed Sarkhy
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  2. Rabindranath Persad
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  3. Mark Tarnopolsky
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Correspondence to Rabindranath Persad.

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Sarkhy, A., Persad, R. & Tarnopolsky, M. Muscle weakness in a girl with autoimmune hepatitis and Graves’ disease. Eur J Pediatr 168, 241–243 (2009). https://doi.org/10.1007/s00431-008-0738-6

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  • DOI: https://doi.org/10.1007/s00431-008-0738-6

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