Primary biliary cirrhosis associated with myasthenia gravis after postpartum: a case report

J Med Case Rep. 2021 Oct 10;15(1):498. doi: 10.1186/s13256-021-03092-x.

Abstract

Background: Autoimmune diseases refers to a class of diseases involving abnormal immune response of human body and tissue damage caused by the dysregulation of autoimmune balance or destruction of immune tolerance. Recent research has revealed that the occurrence of autoimmune diseases is influenced by genetic, hormonal, immunological, and environmental factors. As sex hormone levels change obviously during pregnancy and postpartum, the morbidity and recurrence rate of autoimmune diseases increase during this period.

Case presentation: A 31-year-old Asian woman was admitted to our hospital for myasthenia gravis and treated with methylprednisolone and pyridostigmine bromide 3 months postpartum. Physical examination and laboratory inspection after admission suggested that the patient had primary biliary cirrhosis. Subsequently, azathioprine was added to the treatment, and the symptoms of both diseases were successfully controlled.

Conclusions: This case exhibits a rare condition of myasthenia gravis combined with primary biliary cirrhosis postpartum. Given the fluctuation of the immune status during the postpartum period, combined autoimmune diseases need to be taken into account when patients develop clinical symptoms of an autoimmune disease. Therefore, detailed physical and laboratory examination can help to prevent the missed diagnosis of these diseases.

Keywords: Myasthenia gravis; Postpartum; Primary biliary cirrhosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Humans
  • Liver Cirrhosis, Biliary* / complications
  • Liver Cirrhosis, Biliary* / diagnosis
  • Liver Cirrhosis, Biliary* / drug therapy
  • Myasthenia Gravis* / complications
  • Myasthenia Gravis* / diagnosis
  • Myasthenia Gravis* / drug therapy
  • Neoplasm Recurrence, Local
  • Postpartum Period
  • Pregnancy
  • Pyridostigmine Bromide

Substances

  • Pyridostigmine Bromide