重症肌无力合并肉芽肿性肌炎一例并文献复习  

Granulomatous Myositis Associated with Myasthenia Gravis:A Rare Case Report and Literature Review

作　　者：刘海燕 瞿千千[1] 史杰婧 张燕[1] 崔文豪 吕海东[1] LIU Hai-yan;QU Qian-qian;SHI Jie-jing;ZHANG Yan;CUI Wen-hao;LYU Hai-dong(Department of Neurology,Jiaozuo People's Hospital of Henan Province,Jiaozuo 454002,Henan Province,China)

机构地区：[1]河南省焦作市人民医院神经内科,河南焦作454002

出　　处：《罕少疾病杂志》2022年第6期14-16,19,共4页Journal of Rare and Uncommon Diseases

摘　　要：肉芽肿性肌炎(GrM)是一组发生在横纹肌的非特异性上皮样肉芽肿性炎性反应综合征,临床上多表现为肌痛、肌无力、皮下结节和吞咽困难,可有肌酶不同水平的升高、炎性肌病的神经电生理表现。病理检查是确诊的主要手段,典型的肌肉病理可发现多核巨细胞和肌纤维炎性改变。肉芽肿性肌炎最常与结节病和结缔组织疾病伴发[1],少有同时合并重症肌无力的病例报道。我们在临床中发现了1例罕见的重症肌无力合并肉芽肿性肌炎的患者,从诊断和治疗过程中吸取了一定的经验教训,现对该病例和文献报道的7例类似病例进行分析,初步概括其特点,为临床同道提供借鉴。Granulomatous myositis(GrM)is a myositis syndrome associated with non-specific epithelioid granulomatous inflammation of striated muscle.It may present as myalgia,myasthenia,subcutaneous nodules and dysphagia,as well as varying levels of muscle enzymes and neuroelectrophysiological changes of myositis.Muscle biopsy is the main means of diagnosis and typical pathological examination could find multinucleat giant cells and inflammatory reaction of myofibrary.Although GrM most frequently related to sarcoidosis and connective tissue diseases[1],reports of patients with concomitant manifestation of thymoma-MG are seldom.We report a rare myasthenia gravis patient complicated with granulomatous myositis,and draw some lessons from the diagnosis and treatment.Analyze of seven similar cases reported in the literature may provide reference for clinical peers through the preliminarily summary of their characteristics.

关 键 词：肉芽肿性肌炎 重症肌无力 胸腺瘤 

分 类 号：R746.1[医药卫生—神经病学与精神病学]