{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:40:02Z","timestamp":1756327202153,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,12,20]]},"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>An 81-year-old woman presented with neck weakness, dysarthria, dysphasia and left-sided ptosis. Myasthenia gravis (MG) was strongly suspected. Voltage gated calcium channel (VGCC) antibodies, associated with Lambert-Eaton myasthenic syndrome (LEMS), were negative. Acetylcholine receptor (AChR) antibody level was 536\u2009nmol\/L and diagnosis of MG was confirmed. Imaging revealed a pelvic mass and subsequent biopsy confirmed a pelvic follicular lymphoma. Our searches revealed this to be the first documented case of MG associated with a pelvic follicular lymphoma. She underwent radiotherapy to treat the lymphoma and received both pyridostigmine and immunosuppression to treat the MG. Her AChR antibody level decreased to 38\u2009nmol\/L and her MG symptoms resolved aside from head drop which is continuing to improve. Her lymphoma is now in remission. We have presented a case with a successful outcome, which highlights the importance of screening for lymphoma and thymoma in new presentations of MG.<\/jats:p>","DOI":"10.1136\/bcr-2021-248011","type":"journal-article","created":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T11:22:55Z","timestamp":1642072975000},"page":"e248011","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Myasthenia gravis associated with a pelvic follicular lymphoma"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3525-5006","authenticated-orcid":false,"given":"Charlotte","family":"Willis","sequence":"first","affiliation":[{"name":"Gastroenterology Department, Stoke Mandeville Hospital, Aylesbury, UK"},{"name":"Radcliffe Department of Medicine, University of Oxford Medical Sciences Division, Oxford, Oxfordshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Max","family":"Williamson","sequence":"additional","affiliation":[{"name":"Radcliffe Department of Medicine, University of Oxford Medical Sciences Division, Oxford, Oxfordshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Constantinou","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Stoke Mandeville Hospital, Aylesbury, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Johns","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Stoke Mandeville Hospital, Aylesbury, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,1,13]]},"reference":[{"key":"2025082713005036000_15.1.e248011.1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/834291."},{"key":"2025082713005036000_15.1.e248011.2","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1111\/nyas.13522","article-title":"Myasthenia gravis: the role of complement at the neuromuscular junction","volume":"1412","author":"Howard","year":"2018","journal-title":"Ann N Y Acad Sci"},{"key":"2025082713005036000_15.1.e248011.3","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-04-0735"},{"key":"2025082713005036000_15.1.e248011.4","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1111\/j.1749-6632.1966.tb45497.x","article-title":"The pathology of the thymus gland in myasthenia gravis","volume":"135","author":"Castleman","year":"1966","journal-title":"Ann N Y Acad Sci"},{"key":"2025082713005036000_15.1.e248011.5","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2011.615426"},{"key":"2025082713005036000_15.1.e248011.6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1979.03300190036022"},{"key":"2025082713005036000_15.1.e248011.7","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20169"},{"key":"2025082713005036000_15.1.e248011.8","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-005-1050-4"},{"key":"2025082713005036000_15.1.e248011.9","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejim.2005.10.007","article-title":"Myasthenia gravis associated with a B-cell, non-Hodgkin's lymphoma","volume":"17","author":"Manckoundia","year":"2006","journal-title":"Eur J Intern Med"},{"key":"2025082713005036000_15.1.e248011.10","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1007\/s00415-014-7532-3","article-title":"Efficacy and safety of rituximab for myasthenia gravis: a systematic review and meta-analysis","volume":"262","author":"Iorio","year":"2015","journal-title":"J Neurol"},{"key":"2025082713005036000_15.1.e248011.11","doi-asserted-by":"crossref","first-page":"2990","DOI":"10.1080\/10428194.2018.1443336","article-title":"Hodgkin lymphoma presenting with paraneoplastic myasthenia: a case report","volume":"59","author":"Nanni","year":"2018","journal-title":"Leuk Lymphoma"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-248011","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:00:57Z","timestamp":1756324857000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-248011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,13]]},"published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1136\/bcr-2021-248011"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-248011","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,1]]}}}