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In late April, 1981, a 72-year-old woman who had suffered from diabetes mellitus for 35 years suddenly developed diplopia, which was soon followed by right blephaloptosis.The symptoms were worse in the evenings than in the mornings.She was admitted to our hospital on May 1, 1981, and was diagnosed as myasthenia gravis with thymoma. We treated her with pyridostigmine bromide.In late May, she suffered from myocardial infarction with a myasthenic crisis.In mid-June, she received steroid hormone treatmets and, in mid-July, her symptoms disappeared. In early September, she again suffered from diplopia and blephaloptosis, but increased doses of steroid hormone were not effective this time.She underwent thymectomy on October 7, and remained well until mid-November.Plasmapheresis treatments were then undertaken in December, and after that time her symptoms were relieved.She continued in good health by receiving plasmapheresis treatments once every 2 weeks and taking steroid hormone and pyridostigmine bromide. In mid-April, 1982, blephaloptosis reappeared and she received plasmapheresis more frequently. In June, she began azathiopurine treatment also.She was discharged in September. The anti-acetylcholine receptor antibodies titer increased and decreased compatibly with the clinical symptoms. She was treated with insulin injections to prevent development of diabetic microangiopathy.
一般社団法人日本糖尿病学会の論文