クロカワ　カツミ   Katsumi Kurokawa   黒川　勝己    所属   川崎医科大学  医学部 臨床医学　総合内科学１    職種   教授
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	Pseudo-internuclear ophthalmoplegia as a sign of overlapping myasthenia gravis in a patient with 'intractable' hypothyroidism.
掲載誌名	正式名：Internal medicine 略　 称：Intern Med ISSNコード：09182918/13497235
巻・号・頁	49(1),pp.69-72
著者・共著者	Yamazaki Yuu, Sugiura Tomohito, Kurokawa Katsumi
担当区分	最終著者
発行年月	2010/01
概要	We describe a 52-year-old man with a history of increasing fatigability and gait disturbances that were first attributed to hypothyroidism. On examination, he had bilateral pseudo-internuclear ophthalmoplegia with weakness of adduction and abducting nystagmus. Convergence was also impaired and he showed proximal weakness of the limb. Intravenous edrophonium almost completely abolished the nystagmus and adducting muscle weakness, and improved the strength of proximal muscles groups. The clinical response to the administration of edrophonium, the presence of AChR binding antibodes and the repetitive nerve stimulation test findings indicated that the patient had pseudo-internuclear ophthalmoplegia as a manifestation of generalized myasthenia gravis. Whereas hypothyroidism was effectively controlled with levothyroxine, his subsequent response to thymectomy, prednisolone and cholinesterase inhibitors confirmed the diagnosis of generalized myasthenia gravis.