Comorbidity of Myasthenia gravis and Graves' disease as immune reconstitution‐associated autoimmune disease in HIV infection: A case report and literature review

Author:

Lu Lianfeng1,Ma Yanan1,Cong Yang1,Zhou Baotong1,Chen Yeye1,Niu Jingwen1,He Yun2,Cao Wei1,Li Taisheng134ORCID

Affiliation:

1. Peking Union Medical College Hospital Peking Union Medical College and Chinese Academy of Medical Sciences Beijing China

2. Department of Infectious Diseases The Third People's Hospital of Shenzhen: Second Affiliated Hospital of Southern University of Science and Technology Shenzhen China

3. Department of Basic Medical Sciences, School of Medicine Tsinghua University Beijing China

4. State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College Beijing China

Abstract

AbstractBackgroundComorbidity of Myasthenia gravis (MG) and Graves' disease (GD) in treated HIV‐infected individuals has rarely been described and little study has been done on the link between HIV‐related immune reconstitution and autoimmune diseases occurring post antiretroviral therapy.Case PresentationHere we report on a 33‐year‐old Chinese man with HIV infection who had been virologically suppressed since 2018. The patient was diagnosed with GD and was treated in 2020. Early in 2022, he developed fluctuating weakness and fatigue involving the bilateral extraocular muscles and limbs. With a positive neostigmine test, he was considered to have MG, but showed a poor response to oral medication. After multiple failed medication attempts, a thymectomy was finally performed to resolve his symptoms. The consecutive onset of immunological events may have partially resulted from immune reconstitution after viral control.ConclusionsThis is a rare case of HIV‐related immune reconstitution‐associated autoimmune disease (IRAD) with comorbidity of MG and GD which was reported initially. Cooperation with multidisciplinary teams is essential to avoid misdiagnosis and to promote the overall health of HIV‐infected patients.

Publisher

Wiley

Subject

Pharmacology (medical),Infectious Diseases,Health Policy

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