{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T04:09:20Z","timestamp":1779336560451,"version":"3.51.4"},"reference-count":10,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The coexistence of myasthenia gravis (MG) and chronic kidney disease (CKD) presents a diagnostic challenge due to overlapping clinical features. MG is an autoimmune neuromuscular junction disorder, whereas CKD exhibits the gradual loss of kidney function. We report a 65\u2010year\u2010old male with long\u2010standing CKD who developed progressive neuromuscular symptoms, including bilateral ptosis and bulbar involvement. His anti\u2010acetylcholine receptor antibodies were negative; however, electrophysiological studies demonstrated a significant decremental response (&gt;\u200910%) on repetitive nerve stimulation, supporting the diagnosis of MG. The patient required hemodialysis for worsening renal function and was treated with pyridostigmine for MG symptoms, resulting in clinical improvement. This case emphasizes the importance of distinguishing MG from CKD\u2010related symptoms, particularly in seronegative patients, and highlights the need for careful clinical and electrophysiological evaluation.<\/jats:p>","DOI":"10.1002\/ccr3.72758","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T03:44:17Z","timestamp":1779335057000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Myasthenia Gravis With Chronic Kidney Disease: A Diagnostic Challenge"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9833-4115","authenticated-orcid":false,"given":"Zahra","family":"Mahmood","sequence":"first","affiliation":[{"name":"Department of Nephrology Jinnah Postgraduate Medical Centre  Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1948-2812","authenticated-orcid":false,"given":"Amina","family":"Mahmud","sequence":"additional","affiliation":[{"name":"Dow University of Health Sciences  Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9393-1215","authenticated-orcid":false,"given":"Aymar","family":"Akilimali","sequence":"additional","affiliation":[{"name":"Department of Research Medical Research Circle (MedReC)  Goma Democratic Republic of the Congo"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"issue":"10075","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1016\/S0140-6736(16)32064-5","article-title":"Chronic Kidney Disease","volume":"389","author":"Webster A. C.","year":"2017","journal-title":"Lancet"},{"issue":"1","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.3109\/08860229509036377","article-title":"Interpretation of Positive Edrophonium (Tensilon) Test in Patients With End\u2010Stage Renal Disease","volume":"17","author":"Khan G. A.","year":"1995","journal-title":"Renal Failure"},{"issue":"7","key":"e_1_2_11_4_1","first-page":"1025","article-title":"Seronegative Myasthenia Gravis: Clinical Features and Response to Treatment in a Population of 53 Patients","volume":"60","author":"Evoli A.","year":"2003","journal-title":"Neurology"},{"issue":"1","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"25","DOI":"10.4038\/cmj.v53i1.224","article-title":"Case of Generalized Myasthenia Gravis With Membranous Nephropathy","volume":"53","author":"Prasad K. P. R.","year":"2008","journal-title":"Ceylon Medical Journal"},{"issue":"5","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.pneumo.2009.06.003","article-title":"Glom\u00e9rulon\u00e9phrite et thymome: un cas clinique et revue de la litt\u00e9rature","volume":"65","author":"Zbiti N.","year":"2009","journal-title":"Revue de Pneumologie Clinique"},{"issue":"3","key":"e_1_2_11_7_1","first-page":"731","article-title":"Inflammatory Cytokines in CKD","volume":"87","author":"Chung A. C.","year":"2015","journal-title":"Kidney International"},{"issue":"5","key":"e_1_2_11_8_1","first-page":"439","article-title":"Cytokine Profiles in MG and Their Therapeutic Implications","volume":"15","author":"Le Panse R.","year":"2016","journal-title":"Autoimmunity Reviews"},{"issue":"3","key":"e_1_2_11_9_1","first-page":"563","article-title":"Uremic Toxins: A Key Player in CKD Progression","volume":"29","author":"Vanholder R.","year":"2018","journal-title":"Journal of the American Society of Nephrology"},{"issue":"1","key":"e_1_2_11_10_1","first-page":"120","article-title":"A Rare Case of MG With CKD Successfully Managed by Plasmapheresis","volume":"261","author":"Kim J. H.","year":"2014","journal-title":"Journal of Neurology"},{"issue":"4","key":"e_1_2_11_11_1","first-page":"523","article-title":"Management of Myasthenia Gravis in End\u2010Stage Renal Disease","volume":"58","author":"Chen X. Y.","year":"2018","journal-title":"Muscle & Nerve"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72758","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.72758","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72758","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T03:44:25Z","timestamp":1779335065000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.72758"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":10,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/ccr3.72758"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.72758","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-02-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72758"}}