{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T00:13:49Z","timestamp":1786839229215,"version":"build-2736575974"},"reference-count":40,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":42,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Neuropsiquiatr"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Comorbid autoimmune disorders affect approximately 0.2% of the population. A second autoimmune disease occurs in up to 15% of myasthenia gravis (MG) patients.<\/jats:p><jats:p>To evaluate the association between MG and inflammatory bowel disease (IBD).<\/jats:p><jats:p>We conducted a cross-sectional study involving a Brazilian cohort of IBD patients and a literature review.<\/jats:p><jats:p>In 2022, we found 1 MG patient with ulcerative colitis and 3 with Crohn's disease out of 606 IBD patients (0.66% prevalence). The patient with UC and MG died in April 2024. The mean IBD onset age was 33.5\u2009\u00b1\u20092.7; patients were 45.8\u2009\u00b1\u20097.3-years-old at evaluation. Further, 2 patients were acetylcholine receptor antibody positive, 1 was anti-muscle specific kinase positive, and 1 seronegative. Also, 3 had abnormal repetitive nerve stimulation, all had normal nerve conduction studies, abnormal skin wrinkling test, and mild small fiber neuropathy. None had thymoma and\/or underwent thymectomy. According to the MG Foundation's classification, one was class V, one IVb, and two IIa. The MG diagnosis was masked by immunotherapy in all. The prevalence ratio of MG in IBD patients versus the proportion of MG among all patients in our center was 8.56 (p\u2009&lt;\u20090.0001, CI\u2009=\u20093.1\u201323.5). Considering the lowest and highest prevalence of this condition reported in the literature, the ratio is 44.0 (p\u2009&lt;\u20090.0001, CI: 16.3\u2013118.4) and 26.4 (p\u2009&lt;\u20090.0001, CI: 9.8\u201370.6), respectively.<\/jats:p><jats:p>The prevalence of MG is higher in IBD, may include muscle specific kinase positive disease (first report in the literature) and frequently overlaps with other autoimmune conditions and small fiber neuropathy.<\/jats:p>","DOI":"10.1055\/s-0045-1807717","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T23:20:13Z","timestamp":1747178413000},"page":"001-009","source":"Crossref","is-referenced-by-count":6,"title":["The prevalence of myasthenia gravis is increased in inflammatory bowel disease"],"prefix":"10.1055","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4590-812X","authenticated-orcid":false,"given":"Ant\u00f4nio Miguel Furtado","family":"Leit\u00e3o","sequence":"additional","affiliation":[{"name":"Universidade Federal do Cear\u00e1, Faculdade de Medicina, Departamento de Morfologia, Fortaleza CE, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6103-4138","authenticated-orcid":false,"given":"Florian P.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Hackensack University Medical Center, Hackensack Meridian School of Medicine, Department of Neurology, Hackensack NJ, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2376-3433","authenticated-orcid":false,"given":"Marcellus Henrique Loiola Ponte de","family":"Souza","sequence":"additional","affiliation":[{"name":"Universidade Federal do Cear\u00e1, Faculdade de Medicina, Departamento de Medicina Cl\u00ednica, Servi\u00e7o de Gastroenterologia, Fortaleza CE, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8258-4684","authenticated-orcid":false,"given":"L\u00facia Libanez Bessa Campelo","family":"Braga","sequence":"additional","affiliation":[{"name":"Universidade Federal do Cear\u00e1, Faculdade de Medicina, Departamento de Medicina Cl\u00ednica, Servi\u00e7o de Gastroenterologia, Fortaleza CE, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8957-5796","authenticated-orcid":false,"given":"Francisco de Assis Aquino","family":"Gondim","sequence":"additional","affiliation":[{"name":"Universidade Federal do Cear\u00e1, Faculdade de Medicina, Departamento de Medicina Cl\u00ednica, Servi\u00e7o de Neurologia, Fortaleza CE, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"publisher","first-page":"e32487","DOI":"10.1371\/journal.pone.0032487","article-title":"Population based study of 12 autoimmune diseases in Sardinia, Italy: prevalence and comorbidity","volume":"7","author":"C Sardu","year":"2012","journal-title":"PLoS One"},{"issue":"26","key":"ref2","doi-asserted-by":"publisher","first-page":"2570","DOI":"10.1056\/NEJMra1602678","article-title":"Myasthenia Gravis","volume":"375","author":"N E Gilhus","year":"2016","journal-title":"N Engl J Med"},{"issue":"05","key":"ref3","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1111\/joim.12310","article-title":"The autoimmune spectrum of myasthenia gravis: a Swedish population-based study","volume":"277","author":"F Fang","year":"2015","journal-title":"J Intern Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1056\/NEJM196401302700504","article-title":"Systemic lupus erythematosus, cirrhosis and ulcerative colitis after thymectomy for myasthenia gravis","volume":"270","author":"R F Galbraith","year":"1964","journal-title":"N Engl J Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1212\/wnl.45.3.416","article-title":"Neurologic aspects of inflammatory bowel disease","volume":"45","author":"A Lossos","year":"1995","journal-title":"Neurology"},{"issue":"02","key":"ref6","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1590\/0004-282","article-title":"A case-control study of the prevalence of neurological diseases in inflammatory bowel disease (IBD)","volume":"73","author":"FdA Gondim","year":"2015","journal-title":"Arq. Neuro-Psiquiatr."},{"issue":"11","key":"ref7","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1016\/j.nmd.2014.06.434","article-title":"Two patients with co-morbid myasthenia gravis in a Brazilian cohort of inflammatory bowel disease","volume":"24","author":"FdA Gondim","year":"2014","journal-title":"Neuromuscul Disord"},{"issue":"08","key":"ref8","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1590\/0004-282","article-title":"Small fiber dysfunction in patients with Wilson's disease","volume":"72","author":"FdA Gondim","year":"2014","journal-title":"Arq. Neuro-Psiquiatr."},{"issue":"07","key":"ref9","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1007\/s00296-009-1012-6","article-title":"Successful resolution of pneumonia developed in a patient affected by Crohn's disease, rheumatoid arthritis, myasthenia gravis and recurrent uveitis during concomitant treatment with tumour necrosis factor alpha inhibitors and conventional immunosuppressive drugs","volume":"30","author":"E Angelucci","year":"2010","journal-title":"Rheumatol Int"},{"issue":"02","key":"ref10","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1136\/gut.35.2.278","article-title":"Crohn's disease and myasthenia gravis: a possible role for thymectomy","volume":"35","author":"I A Finnie","year":"1994","journal-title":"Gut"},{"issue":"11","key":"ref11","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.1007\/s00296-008-0579-7","article-title":"Associated thyreoiditis, myasthenia gravis, thymectomy, Chron's disease, and erythema nodosum: pathogenetic and clinical correlations, immune system involvement, and systemic infectious complications","volume":"28","author":"R Manfredi","year":"2008","journal-title":"Rheumatol Int"},{"issue":"01","key":"ref12","first-page":"112","article-title":"Myasthenia gravis coexistent with Crohn's disease","volume":"13","author":"R W Martin","year":"1991","journal-title":"J Clin Gastroenterol"},{"issue":"05","key":"ref13","doi-asserted-by":"publisher","first-page":"1242","DOI":"10.1002\/ncp.10800","article-title":"High-dose vitamin C therapy for symptomatic deficiency in a patient with myasthenia gravis and Crohn's disease","volume":"37","author":"J Murphree","year":"2022","journal-title":"Nutr Clin Pract"},{"issue":"06","key":"ref14","doi-asserted-by":"publisher","first-page":"2333","DOI":"10.1016\/j.athoracsur.2015.02.116","article-title":"Primary Ectopic Mediastinal Goiter in a Patient With Crohn's Disease Presenting as Myasthenia Gravis","volume":"100","author":"S Kumar","year":"2015","journal-title":"Ann Thorac Surg"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.24966\/ACC-8879\/100007","article-title":"Thymectomy in a patient with myasthenia gravis and Crohn's disease \u2013 Anaesthetic Challenges","volume":"2","author":"R Garg","year":"2015","journal-title":"J Anesth Clin Care"},{"issue":"02","key":"ref16","first-page":"165","article-title":"Some clinico-immunological aspects in patients with ocular myasthenia gravis associated with inflammatory bowel disease","volume":"46","author":"I M Cojocaru","year":"2008","journal-title":"Rom J Intern Med"},{"issue":"01","key":"ref17","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1111\/j.1443-1661.1993.tb00601.x","article-title":"A case of inflammatory bowel disease accompanied by myasthenia gravis","volume":"5","author":"K Takechi","year":"1993","journal-title":"Dig Endosc"},{"issue":"09","key":"ref18","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.1136\/bjo.87.9.1186","article-title":"Ocular myasthenia gravis and inflammatory bowel disease: a case report and literature review","volume":"87","author":"R Foroozan","year":"2003","journal-title":"Br J Ophthalmol"},{"issue":"07","key":"ref19","first-page":"1136","article-title":"Remission of myasthenia gravis after proctocolectomy in a patient with ulcerative colitis","volume":"88","author":"C Gower-Rousseau","year":"1993","journal-title":"Am J Gastroenterol"},{"issue":"36","key":"ref20","first-page":"2860","article-title":"[Myasthenia gravis in patients with ulcerative colitis\u2013an overlooked autoimmune association?]","volume":"89","author":"E Hertervig","year":"1992","journal-title":"Lakartidningen"},{"issue":"04","key":"ref21","first-page":"382","article-title":"Rare association of myasthenia gravis and ulcerative colitis","volume":"14","author":"F Koc","year":"2009","journal-title":"Neurosciences (Riyadh)"},{"issue":"08","key":"ref22","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1111\/j.1532-5415.2004.52379_7.x","article-title":"Dysphagia and unexpected myasthenia gravis associated with primary biliary cirrhosis, ulcerative colitis and vitiligo","volume":"52","author":"P McCann","year":"2004","journal-title":"J Am Geriatr Soc"},{"issue":"08","key":"ref23","first-page":"807","article-title":"Myasthenia gravis, ulcerative colitis and lichen planus","volume":"64","author":"T N Miller","year":"1971","journal-title":"Proc R Soc Med"},{"issue":"08","key":"ref24","doi-asserted-by":"publisher","first-page":"1070","DOI":"10.1136\/gut.35.8.1070","article-title":"The first 10 years' experience of restorative proctocolectomy for ulcerative colitis","volume":"35","author":"P Setti-Carraro","year":"1994","journal-title":"Gut"},{"issue":"03","key":"ref25","first-page":"195","article-title":"Ulcerative colitis, myasthenia gravis, atypical lichen planus, alopecia areata, vitiligo","volume":"67","author":"R S Tan","year":"1974","journal-title":"Proc R Soc Med"},{"issue":"01","key":"ref26","doi-asserted-by":"publisher","first-page":"e246861","DOI":"10.1136\/bcr-2021-246861","article-title":"An unusual presentation of thymoma: dysgeusia, ulcerative colitis, keratoconjunctivitis sicca, autoimmune retinopathy and myasthenia gravis","volume":"15","author":"P Sanghi","year":"2022","journal-title":"BMJ Case Rep"},{"issue":"02","key":"ref27","doi-asserted-by":"publisher","first-page":"ytac046","DOI":"10.1093\/ehjcr\/ytac046","article-title":"Successful bridge to recovery in a patient with fulminant giant cell myocarditis that developed from multiple autoimmune disorders including myasthenia gravis: a case report","volume":"6","author":"N Yagi","year":"2022","journal-title":"Eur Heart J Case Rep"},{"issue":"01","key":"ref28","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.arcped.2014.10.014","article-title":"Unusual association of myasthenia gravis and ulcerative colitis in a 14-year-old boy","volume":"22","author":"C Guinet-Charpentier","year":"2015","journal-title":"Arch Pediatr"},{"issue":"06","key":"ref29","doi-asserted-by":"publisher","first-page":"412","DOI":"10.3109\/08916934.2015.1031890","article-title":"Poly-autoimmunity in patients with myasthenia gravis: A single-center experience","volume":"48","author":"A Evoli","year":"2015","journal-title":"Autoimmunity"},{"issue":"01","key":"ref30","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1186\/s12883-022-02692-4","article-title":"A retrospective longitudinal cohort study of the clinical burden in myasthenia gravis","volume":"22","author":"L Harris","year":"2022","journal-title":"BMC Neurol"},{"issue":"07","key":"ref31","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1016\/j.nmd.2021.05.006","article-title":"Accuracy of patient-reported data for an online patient registry of autoimmune myasthenia gravis and Lambert-Eaton myasthenic syndrome","volume":"31","author":"A M Ruiter","year":"2021","journal-title":"Neuromuscul Disord"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1016\/j.jneuroim.2011.05.008","article-title":"Concomitant autoimmunity in myasthenia gravis--lack of association with IgA deficiency","volume":"236","author":"R Ramanujam","year":"2011","journal-title":"J Neuroimmunol"},{"issue":"07","key":"ref33","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1016\/j.jocn.2015.01.022","article-title":"Clinical features and impact of myasthenia gravis disease in Australian patients","volume":"22","author":"S Blum","year":"2015","journal-title":"J Clin Neurosci"},{"issue":"03","key":"ref34","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1002\/mus.21555","article-title":"Ocular myasthenia gravis in a senior population: diagnosis, therapy, and prognosis","volume":"41","author":"J A Allen","year":"2010","journal-title":"Muscle Nerve"},{"issue":"04","key":"ref35","doi-asserted-by":"publisher","first-page":"1247","DOI":"10.1007\/s10067-022-06062-w","article-title":"Rheumatoid arthritis and myasthenia gravis: a case-based review of the therapeutic options","volume":"41","author":"R Bixio","year":"2022","journal-title":"Clin Rheumatol"},{"issue":"06","key":"ref36","doi-asserted-by":"publisher","first-page":"e8422","DOI":"10.7759\/cureus.8422","article-title":"Association Between Systemic Lupus Erythematosus and Myasthenia Gravis: Coincidence or Sequelae?","volume":"12","author":"S Raut","year":"2020","journal-title":"Cureus"},{"issue":"09","key":"ref37","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1080\/14737175.2019.1600404","article-title":"An update on thymectomy in myasthenia gravis","volume":"19","author":"A Evoli","year":"2019","journal-title":"Expert Rev Neurother"},{"issue":"16","key":"ref38","doi-asserted-by":"publisher","first-page":"8870","DOI":"10.3390\/ijms22168870","article-title":"The Gut-Brain Axis in Inflammatory Bowel Disease-Current and Future Perspectives","volume":"22","author":"C G\u00fcnther","year":"2021","journal-title":"Int J Mol Sci"},{"issue":"12","key":"ref39","doi-asserted-by":"publisher","first-page":"1478","DOI":"10.1111\/apt.16949","article-title":"Systematic review-pancreatic involvement in inflammatory bowel disease","volume":"55","author":"S Massironi","year":"2022","journal-title":"Aliment Pharmacol Ther"},{"issue":"01","key":"ref40","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1186\/s12883-022-02923-8","article-title":"SOX-1 antibodies in a patient with Crohn's disease: a case report","volume":"22","author":"E Polilli","year":"2022","journal-title":"BMC Neurol"}],"container-title":["Arquivos de Neuro-Psiquiatria"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0045-1807717.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T23:20:16Z","timestamp":1747178416000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0045-1807717"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":40,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2025,3,19]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["s00451807717"],"URL":"https:\/\/doi.org\/10.1055\/s-0045-1807717","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0004-282X","1678-4227"],"issn-type":[{"value":"0004-282X","type":"print"},{"value":"1678-4227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}