Immunosuppressive treatment of rippling muscles in patients with myasthenia gravis

ArticleinNeuromuscular Disorders 9(8):604-7 · January 2000with3 Reads
Impact Factor: 2.64 · 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.