6^th World Congress on Internal Medicine and Primary Care October 14-15, 2020 Zurich, Switzerland

Dr. Alsada has completed his Medical degree from Arabian Gulf University, Bahrain. Currently, he is working as a senior medical resident in Salmaniya Medical Complex – Internal Medicine Department. Dr Basem is a consultant rheumatologist at Bahrain Defense force, Bahrain.

Systemic Lupus Erythematosus (SLE) and Myasthenia Gravis (MG) are two distinct diseases, which can coexist or precede each other, however, their occurrence in the same patient is rare. This rare phenomenon has already been observed; however, only sporadic clinical cases have been described. So far, There had been a total of 17 previously published cases of SLE and MG occurring in the same patients. SLE can precede or follow the development of MG. The latter scenario is more rare, as the prevalence of SLE in MG was 2.2%–8.3% and the prevalence of MG in SLE was 1.3%. The aim of this report is to present a case of SLE in a 17-years old girl who was found to have MG many years after the initial diagnosis of SLE. Nerve conduction studies showed the decremental response over facial muscles and right median nerve. In addition, Anti-Acetylcholine receptor (AchR) antibodies were positive, she was treated with oral pyridostigmine 60 mg three times a day. Clinical improvement and resolve of muscular weakness was seen within a couple of days. The patient was discharged on prednisolone 10 mg OD and pyridostigmine 60 mg TDS with a follow up appointment with rheumatology outpatient clinic. In conclusion, the association between SLE and MG is complex. In lupus patients complaining of decreased muscle strength and fatigability, the possibility of MG should be ruled out.