Occurrence of Biermer's Disease After 8 Years of Follow-Up of Myasthenia Gravis: About a Clinical Case
Clinical Neurology and Neuroscience
Volume 1, Issue 1, February 2017, Pages: 5-7
Received: Jan. 19, 2017; Accepted: Feb. 9, 2017; Published: Mar. 1, 2017
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Authors
Soumaila Boubacar, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
Ngor Side Diagne, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
Eric Gueumekane Lamou Bila, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
Christian Madjirabe Ngarndiguina, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
Ibrahima Mariam Diallo, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
Patrice Ntenga, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
Ousmane Cisse, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
Alassane Mamadou Diop, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
Ndiaga Matar Gaye, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
Maouly Fall, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal; Department of Internal Medicine, Hospital of Pikine, Dakar, Senegal
Marième Soda Diop, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
Anna Modji Basse, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
Adjaratou Dieynabou Sow, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
Hamid Assadeck, Faculty of Health Sciences, Abdou Moumouni University, Niamey, Niger
Youssoufa Maiga, Department of Neurology, Gabriel Touré University Hospital, Bamako, Mali
Lala Bouna Seck, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
Kamadore Touré, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
Moustapha Ndiaye, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
Amadou Gallo Diop, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
Mouhamadou Mansour Ndiaye, Department of Neurology, Fann National Teaching Hospital, Dakar, Senegal
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Abstract
The auto immune myasthenia comorbidity and Biermer disease is less documented and rarely brought in the literature. We bring back the observation of a Senegalese patient hospitalized in our department of Neurology at Fann hospital (Dakar). It concerned a patient aged 58 years followed up for auto-immune myasthenia to antibodies anti-receptors of acetylcholine Ac RACH since 8 years and having a benefit of recurrent blood transfusion with a blood group A rhesus positive. He was received on neurologic consultation for a tiredness associated to an effort dyspnea and a gastro esophageal reflux accompanied by vomiting. The interrogatory found palpitations which necessitated a hospitalization two month before. Physical examination had objective a myasthenia syndrome, an anemic syndrome on the other hand, sub icteric mucosa’s were noted but no melanodermia no glossite. The rest of the physical examination was without particularity. The diagnoses of the Biermer illness was carried out in front of the anemic syndrome, the chronicity of the symptomatology without notion of fluctuation and the complementary exams having as objective a low rate of hemoglobin and a deficit in vitamin B12. The origin auto-immune of this anemia was confirmed by the immunologic test which had put in evidence a high rate of anti-bodies anti- intrinsic factor. The patient benefited from a blood transfusion then a treatment from cobalamin (for life) was also installed associated to a symptomatic management of the patient. The evolution after 6 weeks of the treatment was favorable with a complete regression of the dyspnea, vomiting and the attenuation of the effort tiredness. Myasthenia gravis and Biermer disease comorbidity has to be discussed in front of every myasthenia patient presenting clinical signs of effort dyspnea to a chronic anemia because early diagnoses of this association of Biermer illness and myasthenia gravis favors a better prognosis and not to progress to the combined degeneration of the spinal cord. The autoimmune substratum of the mechanism of this comorbidity remains to be elucidated but in all cases multidisciplinary management is necessary.
Keywords
Myasthenia, Biermer’s Disease, Comorbidity, Senegal
To cite this article
Soumaila Boubacar, Ngor Side Diagne, Eric Gueumekane Lamou Bila, Christian Madjirabe Ngarndiguina, Ibrahima Mariam Diallo, Patrice Ntenga, Ousmane Cisse, Alassane Mamadou Diop, Ndiaga Matar Gaye, Maouly Fall, Marième Soda Diop, Anna Modji Basse, Adjaratou Dieynabou Sow, Hamid Assadeck, Youssoufa Maiga, Lala Bouna Seck, Kamadore Touré, Moustapha Ndiaye, Amadou Gallo Diop, Mouhamadou Mansour Ndiaye, Occurrence of Biermer's Disease After 8 Years of Follow-Up of Myasthenia Gravis: About a Clinical Case, Clinical Neurology and Neuroscience. Vol. 1, No. 1, 2017, pp. 5-7. doi: 10.11648/j.cnn.20170101.12
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This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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