Immunosuppressive treatment of rippling muscles in patients with myasthenia gravis

Johannes Gutenberg-Universität Mainz, Mayence, Rheinland-Pfalz, Germany
Neuromuscular Disorders (Impact Factor: 2.64). 01/2000; 9(8):604-7. DOI: 10.1016/S0960-8966(99)00065-6
Source: PubMed


Rippling muscle disease is a rare autosomal dominant disorder that may occur sporadically. In this report two patients presenting with rippling muscles followed by myasthenia gravis are described. Our first patient developed rippling muscles about 1 month after infection with Yersinia enterocolitica. Two years later myasthenia gravis appeared. Our second patient had a 2-year history of asthma prior to the onset of rippling muscles which preceded the myasthenic symptoms by 4-8 weeks. Acetylcholine receptor and anti-skeletal muscle antibody titers were positive in both patients. In both patients the rippling phenomena worsened with pyridostigmine treatment but markedly improved after immunosuppression with azathioprine.

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