Case Report
Myasthenia Gravis Associated with Diabetes about an Observation in Dakar, Senegal (West Africa) and Review of the Literature
Soumaila Boubacar1*, Ngor Side Diagne1, Djibrilla Ben Adji2, Yannick F Fogang1, Youssoufa Maiga3, Douma Maiga4, Moustapha Ndiaye1, Amadou G Diop1 and Mansour Ndiaye M1
1Department of Neurology, Fann National Teaching Hospital Po Box 5035 Dakar, Senegal
2Department of Medicine, National Hospital Po Box 238 Niamey, Niger
3Department of Neurology, Gabriel Touré University Hospital Po Box 267 Bamako, Mali
4Faculty of health sciences, University of Maradi Po Box 465 Maradi, Niger
- Corresponding Author:
- Soumaila Boubacar
Department of Neurology
Fann National Teaching Hospital Po Box 5035 Dakar, Senegal
Tel: 971556864636
E-mail: abounadjma@yahoo.fr
Received date: April 19, 2016; Accepted date: May 02, 2016; Published date: May 09, 2016
Citation: Boubacar S, Diagne NS, Adji DB, Fogang YF, Maiga Y, et al. (2016) Myasthenia Gravis Associated with Diabetes about an Observation in Dakar, Senegal (West Africa) and Review of the Literature. Adv Mol Diag 1:101. doi:10.4172/amd.1000 105
Copyright: © 2016 Boubacar S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Myasthenia gravis is a rare disease with very few confirmed cases described in the African setting. We report the case of a 41-year-old woman with a history of type 2 diabetes, high blood pressure (well monitored), and migraine with aura. She was received at the outpatient neurology consultation for a left ptosis, diplopia, chewing and walking difficulties. She reported abnormal and fluctuating muscle fatigability at effort, responsible for several falls. These symptoms were marked at evening, and were evolving since four years before her consultation in our center. She also reported a history of palpitations, exertional dyspnea, dysphonia, dysphagia and 20 kg weight loss. Neurological examination found a horizontal diplopia, a left ptosis and abnormal weakness at dynamic eyes and limb muscles testing. Otherwise the remaining neurological examination was unremarkable. Repetitive nerve stimulation found a significant compound muscle action potentials decrement. The immunological tests showed a very high level of antibodies to acetylcholine receptors (anti-AChR) at 1220.00 nmol/l (normal value <0.40 nmol/l). Thyroid tests and the remaining biological tests were normal. Thorax CT-scan was normal, with no thymoma. Considering these results, the diagnosis of anti-AchR myasthenia gravis was established. She was started on pyridostigmine 60 mg four times daily associated to her previous hypertension and diabetes therapy. Outcome after five months of treatment was marked by a complete recovery of muscle weakness and weight. Myasthenia gravis is a rare disease, frequently leading to a misdiagnosis. His association with diabetes is well established. It is worth to think about it when dealing with patients presenting fatigue with a history of diabetes.
