A Case of Myasthenia Gravis Following Alopecia Areata

December 2023 in “ Journal of Cutaneous Immunology and Allergy ”

Naoki Sasaki, Yu Sawada

alopecia areata myasthenia gravis hair loss prednisolone tacrolimus autoimmune diseases Th1-dominant immunological involvement AA MG

From the encyclopedia

Alopecia Areata →

autoimmune disorder causing patchy hair loss

Prednisolone →

Studysummary In this case report, a 41-year-old male developed myasthenia gravis following alopecia areata, with prednisolone and tacrolimus improving his symptoms; a literature review identified 29 reported cases of this comorbidity, with some showing additional autoimmune diseases, suggesting a shared immunological mechanism.

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This case report describes a 41-year-old male who developed myasthenia gravis (MG) following alopecia areata (AA). The patient initially experienced hair loss, which was confirmed as AA through clinical and histological analysis. Subsequently, he developed symptoms of MG, including drooping eyelids and diplopia, which were alleviated with edrophonium and confirmed by elevated antiacetylcholine receptor antibodies. Treatment with prednisolone and tacrolimus improved both conditions. The report highlights the comorbidity of AA and MG, noting that out of 29 reported cases, 7 developed MG after AA, with an average onset time of 16.6 months. The study suggests a potential immunological link between the two conditions, possibly involving acetylcholine receptors in hair follicles. The authors emphasize the need for caution due to the risk of exacerbation of these autoimmune diseases.

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Research cited in this study

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research Lifestyle Factors Involved in the Pathogenesis of Alopecia Areata

16 citations , January 2022 in “International journal of molecular sciences”

This review summarizes the influences of lifestyle factors such as smoking, alcohol, and diet on the pathogenesis of alopecia areata but reports no new clinical results.

research Alopecia Areata and Myasthenia Gravis Presenting as Paraneoplastic Phenomena of Breast Cancer

3 citations , January 2022 in “JAAD Case Reports”

This article reports a unique case of a 60-year-old woman with alopecia areata and myasthenia gravis, suggesting a rare paraneoplastic syndrome connection primarily limited to prior reports involving hematologic cancers.

research Non-Motor Comorbidity of Myasthenia Gravis: Myasthenia Gravis as a Systemic Immunological Disorder Involving Non-Motor Systems

10 citations , December 2018 in “Internal Medicine”

This study reports two cases of myasthenia gravis patients with thymoma who exhibited various autoimmune symptoms including alopecia, suggesting a link between thymus-related immune dysregulation and comorbid conditions.

research Multiple Paraneoplastic Syndromes: Myasthenia Gravis, Vitiligo, Alopecia Areata, and Oral Lichen Planus Associated with Thymoma

31 citations , June 2011 in “Journal of the neurological sciences”

In this case report, a patient with thymoma was observed to have four co-occurring paraneoplastic autoimmune disorders that improved after thymectomy, suggesting a possible link between thymoma and these conditions.

research Alopecia Areata Associated With Myasthenia Gravis And Thymoma: A Case Of Alopecia With Marked Improvement Following Thymectomy And High-Level Prednisolone Administration

21 citations , December 1997 in “The Journal of Dermatology”

In this case report, a 57-year-old Japanese woman with alopecia areata, associated with myasthenia gravis and thymoma, showed significant improvement after undergoing thymectomy and receiving high doses of glucocorticosteroids.

research Generalized Trichoepitheliomas With Alopecia and Myasthenia Gravis: Clinicopathologic and Immunohistochemical Study and Comparison With Classic and Desmoplastic Trichoepithelioma

54 citations , November 1986 in “Journal of the American Academy of Dermatology”

This case report identifies a potential new syndrome characterized by trichoepitheliomas and alopecia, which may be associated with myasthenia gravis.

research Generalized Hair Follicle Hamartoma Associated With Alopecia And Myasthenia Gravis: Report Of A Second Case

64 citations , May 1981 in “Clinical and Experimental Dermatology”

This case report describes a patient with myasthenia gravis, alopecia, and hair follicle hamartoma, showing notable similarities to a previously reported case.

research Generalized Hair-Follicle Hamartoma

61 citations , April 1969 in “Archives of Dermatology”

This study highlights a case where progressive baldness initially diagnosed as alopecia universalis was attributed to a basal cell hamartoma of each hair follicle, stressing the importance of skin biopsies for unusual alopecia cases.