ArticleCureus2026
Sodium-Glucose Linked Transporter-2 (SGLT-2) Inhibitor-Associated Unmasking of Myasthenia Gravis in a Patient With Undiagnosed Thymic Follicular Hyperplasia: The First Reported Case.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Myasthenia gravis is an autoimmune disease of the neuromuscular junction, primarily caused by antibodies directed against the acetylcholine receptor. Follicular hyperplasia of the thymus can be seen in patients with acetylcholine receptor-positive myasthenia gravis and may remain asymptomatic for many years until unmasked by a specific medication. Myasthenia gravis induced by drugs has been reported with D-penicillamine and immune checkpoint inhibitors, but never with the sodium-glucose linked transporter-2 inhibitors. We report a case of a 62-year-old man with type 2 diabetes presenting with progressive, fluctuating bilateral ptosis, binocular diplopia, dysarthria, and dysphagia occurring eight weeks after starting treatment with 10 mg daily of empagliflozin. He had no history of any other medications or infections. Physical examination revealed fluctuating bilateral ptosis (more prominent on the right) with an ice pack test demonstrating a 2 mm improvement after two minutes. The anti-acetylcholine receptor antibody level was positive at 4.2 nmol/L. Repetitive nerve stimulation studies revealed an 18% decremental response at 3 Hz. A chest computed tomography scan showed diffuse bilateral symmetric thymic hyperplasia measuring 12 mm in size without any mass. Empagliflozin was discontinued. Pyridostigmine and prednisone 40 mg daily were started, with full resolution of his symptoms. The patient shows no symptoms at one year on pyridostigmine alone. This case represents the first description of the unmasking of acetylcholine receptor-positive myasthenia gravis by sodium-glucose linked transporter-2 inhibitors in a patient with thymic follicular hyperplasia. Myasthenia gravis should be considered in patients with newly acquired fatigable ptosis, diplopia, or bulbar symptoms who are being treated with sodium-glucose linked transporter-2 inhibitors.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.