Myasthenia gravis as an unusual non-hematological autoimmune manifestation of a relapsed chronic lymphocytic leukemia – clinical case and review of literature

S. Dimitrova, M. Efraim, I. Micheva

Department of Hematology, Medical University, UMHAT “Sveta Marina”, Varna, Bulgaria. stelladimitrova@abv.bg

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• Hematology
• Immunology

BACKGROUND: Autoimmune phenomena are well known to complicate chronic lymphocytic leukemia (CLL) and occur in 10% to 25% of the cases. Although less common, non-hematological autoimmune manifestations have been reported. Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction, characterized by fatigable weakness of the extraocular, bulbar, and limb musculature. The co-existence of MG and CLL is exceedingly rare and there are very few cases reported in literature.

CASE PRESENTATION: We present a case of a 63-year-old female patient with a severe form of MG which is likely related to a relapse of CLL. Treatment with combined targeted and immunotherapy was initiated with acceptable tolerability.

CONCLUSIONS: Targeted agents and monoclonal antibodies exert complex activities on the patient’s immune system. It will be of interest to assess their role in managing autoimmune complications, accompanying CLL.

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