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Permalink : https://petit.lib.yamaguchi-u.ac.jp/4159
山口医学 Volume 54 Issue 2-3
published_at 2005-06-30
A case of polymyositis simultaneously complicated with myasthenia gravis
多発筋炎に重症筋無力症を同時期に合併した1症例
Sakuragi Shizu
Mitani Noriyuki
Tanaka Yoshinori
Matsui Kumiko
Matsuda Kazuhiro
Shinohara Kenji
Hirata Ikuo
About This Article
Descriptions
68歳, 女性.2ヵ月前より両大腿筋肉痛, 筋力低下, 両肩・両膝関節痛が出現し, 立ち上がり, 歩行が困難になった.同時期より眼瞼下垂, 上下肢の易疲労性を認めた.抗核抗体は陽性, 抗アセチルコリンレセプター抗体は著明に高値, 抗Jo-1抗体は陰性であった.エドロフォニウムテストにより眼瞼下垂は改善したが, 上下肢の筋力は改善しなかった.一方CKは上昇し大腿筋生検では筋線維の不揃いの変性, 著明なリンパ球や好中球などの炎症細胞浸潤が認められ, 筋電図は低電位であり反復刺激ではwaningがみられた.これらの所見から重症筋無力症と, 多発筋炎の同時期の合併と考えられた.プレドニゾロンの投与により徐々に大腿の筋力は回復し歩行可能になったが四肢の易疲労性, 眼瞼下垂は残り, 後に塩化アンベノニウムを併用することで, これらの症状は改善した.
Creator Keywords
多発筋炎
重症筋無力症
Rights
本文データは山口大学医学会の許諾に基づきCiNiiから複製したものである