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부실피질 종양과 동반된 중증근무력증 -증례 보고-

Myasthenia Gravis Accompanied by Adrenal Gland Tumor -A Case Report -

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초록

It is unknown that hormone secreting adrenal gland can cause myasthenia gravis. Case: 55 year old man visited our clinic due to episodic diplopia which aggravated at evening. He had long standing uncontrolled hypertension and taken antihypertensive drug without thiazide. One and 3 year before visiting, he had history of transient quadriparesis with hypokalemia (Potassium level 1.9 mmol/L). Antiacethycholinereceptor antibody test was negative. Repetitive nerve stimulation showed generalized decremental response. Left adrenal gland mass was detected at chest CT scan incidentally. Hormonal test was compatible with primary hyperaldosteronism. Left adrenalectomy was done. Repetitive nerve stimulation test which was taken after surgery did not show decremental response. Active hormone secreting adrenal tumor may be cause of secondary myasthenia gravis. More extensive chest CT scan for cover adrenal glands must need in myasthenia with uncontrolled hypertension.

Abstract

It is unknown that hormone secreting adrenal gland can cause myasthenia gravis. Case: 55 year old man visited our clinic due to episodic diplopia which aggravated at evening. He had long standing uncontrolled hypertension and taken antihypertensive drug without thiazide. One and 3 year before visiting, he had history of transient quadriparesis with hypokalemia (Potassium level 1.9 mmol/L). Antiacethycholinereceptor antibody test was negative. Repetitive nerve stimulation showed generalized decremental response. Left adrenal gland mass was detected at chest CT scan incidentally. Hormonal test was compatible with primary hyperaldosteronism. Left adrenalectomy was done. Repetitive nerve stimulation test which was taken after surgery did not show decremental response. Active hormone secreting adrenal tumor may be cause of secondary myasthenia gravis. More extensive chest CT scan for cover adrenal glands must need in myasthenia with uncontrolled hypertension.

참고문헌 (6)

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  3. Raja Rayan DL, "Skeletal muscle channelopathies:nondystrophic myotonias and periodic paralysis", Curr Opin Neurol, 23, pp.466~476 (2010)
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  5. Khan MF, "First report on sequential totally endoscopic thymomectomy and adrenalectomy using computerenhanced telemanipulation", Surg Endosc, 17, pp.1496~1496 (2003)
  6. Yang R, "Hypokalemic periodic paralysis induced by thymic hyperplasia and relieved by thymectomy", JAMA Neurol, 70, pp.1436~1439 (2013)

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