Myasthenia gravis (MG) with rheumatoid arthritis (RA): co-association and co-treatment In a Palestinian female patient

Neuromuscular transmission disorders result from genetic, toxic, or immunological causes and can lead to muscle weakness and fatigue, especially after physical activity.Myasthenia gravis is the most commonly acquired disease caused by autoantibodies attacking signaling proteins at the neuromuscular junction.Other autoimmune diseases, such as autoimmune thyroiditis and systemic lupus erythematosus, are common in MG patients, and a small percentage may also have rheumatoid arthritis. Case presentationA 46-year-old woman was diagnosed with seropositive Rheumatoid Arthritis at 27 and later with Myasthenia Gravis due to muscle weakness.Despite multiple treatment regimens, including Prednisolone, Methotrexate, and etanercept, her disease was not well controlled.Thymectomy alleviates symptoms, followed by a current regimen of hydrocortisone and rituximab. DiscussionMyasthenia gravis (MG) is a neuromuscular autoimmune disorder commonly linked to rheumatoid arthritis (RA).The incidence of RA in MG patients is between 1-4%, while RA patients have a higher prevalence of MG.Methotrexate is a primary treatment for RA, but its effectiveness on MG is limited.Some treatments like etanercept and tocilizumab have shown promise, but others like TNFi and Ipilimumab have caused worsening symptoms or development of MG.Rituximab has been successful in reducing disease symptoms in RA patients. ConclusionMyasthenia gravis linked to RA, methotrexate primary RA treatment, conflicting TNFi effectiveness in MG, tocilizumab, ipilimumab linked to MG onset, rituximab reduces RA symptoms.