ReviewJournal of neurology2012
The association of systemic lupus erythematosus and myasthenia gravis: a series of 17 cases, with a special focus on hydroxychloroquine use and a review of the literature.
Review in Journal of neurology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.
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Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 83 citations in OpenAlex.
- Myasthenia gravis and five autoimmune diseases: a bidirectional Mendelian randomization study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Pooled it
- Guidance for the care of neuromuscular patients during the COVID-19 pandemic outbreak from the French Rare Health Care for Neuromuscular Diseases Network.Revue neurologique · 2020Guideline
- Thymoma-Associated Systemic Lupus Erythematosus and Myasthenia Gravis.Case reports in rheumatology · 2026Article
- Neoadjuvant chemotherapy enabling resection of stage IVA thymoma with myasthenia gravis and systemic lupus erythematosus: a case report.Frontiers in oncology · 2026Article
- A patient treated with ofatumumab for myasthenia gravis in conjunction with systemic lupus erythematosus and thyroid carcinoma.Intractable & rare diseases research · 2024Article
- Cutaneous Lupus Erythematosus: Review and Considerations for Older Populations.Drugs & aging · 2024Review
- Review
- Clinical features of myasthenia gravis with neurological and systemic autoimmune diseases.Frontiers in immunology · 2023Review
- COVID-19 and myasthenia gravis: A review of neurological implications of the SARS-COV-2.Brain and behavior · 2022Review
- Postpartum Myasthenic Crisis in a Patient with SLE: A Case Report and Literature Review.Mediterranean journal of rheumatology · 2022Article
- Myasthenia Gravis: An Unanticipated Cause of Failure to Wean in a Postpartum Patient with Preexisting Systemic Lupus Erythematosus.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- Clinical course and outcome of an outpatient clinic population with myasthenia gravis and COVID-19.Muscle & nerve · 2022Article
- TREATMENT OF MYASTHENIA GRAVIS PATIENTS WITH COVID-19: REVIEW OF THE LITERATURE.Acta clinica Croatica · 2022Review
- MuSK-Myasthenia Gravis Unmasked by Hydroxychloroquine.Case reports in medicine · 2022Article
- COVID-19 Outcomes in Myasthenia Gravis Patients: Analysis From Electronic Health Records in the United States.Frontiers in neurology · 2022Article
- Response to: "MuSK-positive myasthenia may be triggered not only by SARS-CoV-2".European journal of neurology · 2021Article
- Predictive factors for a severe course of COVID-19 infection in myasthenia gravis patients with an overall impact on myasthenic outcome status and survival.European journal of neurology · 2021Article
- Use of Remdesivir in Myasthenia gravis and COVID-19.Pharmacotherapy · 2021Article
- Association Between Myasthenia Gravis and Systemic Lupus Erythematosus as a Comorbid State.Cureus · 2021Review
- Perspectives of Neuro-COVID: Myasthenia.Frontiers in neurology · 2021Article
Corrections and comments
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Authors and funding
14 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The coexistence of systemic lupus erythematosus (SLE) and myasthenia gravis (MG) is rarely reported, and most of the published studies are case reports. Hydroxychloroquine, an antimalarial agent, is an essential treatment in patients with SLE but special caution is recommended when used in MG patients. We retrospectively analyzed the clinical features, laboratory findings, and outcome of 17 patients with both diseases with a special focus regarding hydroxychloroquine use and with a review of the literature. All patients were women. The mean age at MG onset and SLE diagnosis was 34.5 [14-64] and 37.8 [18-72] years, respectively. The presenting symptoms of MG were limb weakness (94%), ocular (88%) and bulbar involvement (53%). Autoantibodies against the acetylcholine receptor were positive in 94% of cases. The main manifestations of SLE included arthritis (88%), cytopenias (53%) and skin rash (41%). Treatment of SLE required hydroxychloroquine (94%), steroids (47%) and immunosuppressive drugs (18%). Among eight patients (47%) who developed MG after initiation of hydroxychloroquine, the question of induction of MG by hydroxychloroquine was raised in one patient. On the other hand, an exacerbation of myasthenic symptoms was only seen in one of the eight patients who received hydroxychloroquine after the diagnosis of MG. Including our cases, we reviewed a total of 70 patients with SLE and MG. Compared with a large series of 1,000 unselected SLE patients, those with associated MG were older, had lower incidence of cutaneous, renal, and neurological manifestations, and higher frequency of anticardiolipin antibodies and lupus anticoagulant. In conclusion, the clinical pattern of patients with SLE and MG seems to be characterized by a less severe course of SLE and higher frequency of antiphospholipid antibodies. Hydroxychloroquine treatment appears to be safe in this setting.
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