The association of pauciarticular juvenile arthritis and myasthenia gravis
J. B. Glass, P. K. Sher, V. A. Lennon and W. E. Regelmann
Department of Pediatrics, University of Minnesota, Minneapolis.
We encountered two children with fluorescent antinuclear antibody-positive
pauciarticular juvenile arthritis who later developed myasthenia gravis.
Acetylcholine receptor binding, blocking, and modulating antibodies,
retrospectively tested on frozen serum, yielded negative results before the
onset of myasthenic symptoms but all yielded strongly positive results
coincident with the onset of weakness. In both children, myasthenia gravis
responded to thymectomy, and one child had a beneficial response to
plasmapheresis. Although, to our knowledge, only two patients with juvenile
arthritis and myasthenia gravis have been described in the past, the
presence of two additional children with both diseases in a single clinic
population suggests that the association may be more prevalent than
previously suspected.