{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T14:46:32Z","timestamp":1786545992589,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T00:00:00Z","timestamp":1554076800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ACG Case Rep J","ACG Case Reports Journal"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The author presents a rare case of overlap syndrome associated with myasthenia gravis in the absence of acetylcholine receptor antibody and thymoma. Various liver autoantibodies developed at different times later in the disease course and myasthenia occurred 5 years after the diagnosis of liver disease. The importance of repeating antibody panel later in the disease course for proper diagnosis and timely treatment is highlighted. The exact mechanism of the development of myasthenia gravis in autoimmune liver disease also needs investigation for the possibility of new drug development that might be beneficial to both.<\/jats:p>","DOI":"10.14309\/crj.0000000000000026","type":"journal-article","created":{"date-parts":[[2019,4,13]],"date-time":"2019-04-13T07:14:10Z","timestamp":1555139650000},"page":"e00026","source":"Crossref","is-referenced-by-count":0,"title":["Overlap Syndrome and Myasthenia Gravis: An Uncommon Association With Unusual Features"],"prefix":"10.14309","volume":"6","author":[{"given":"Gautam","family":"Ray","sequence":"first","affiliation":[{"name":"Gastroenterology Unit, Department of Medicine, B. R. Singh Hospital, Kolkata, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,4,8]]},"reference":[{"issue":"6","key":"R1-20230717","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1093\/ajcp\/74.6.831","article-title":"Hashimoto's thyroiditis, primary biliary cirrhosis, and myasthenia gravis","volume":"74","author":"Rajaraman","year":"1980","journal-title":"Am J Clin Pathol."},{"issue":"5","key":"R2-20230717","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1136\/jnnp.59.5.558","article-title":"Autoimmune chronic active hepatitis and polymyositis in a patient with myasthenia gravis and thymoma","volume":"59","author":"Ko","year":"1995","journal-title":"J Neurol Neurosurg Psychiatry."},{"issue":"4","key":"R3-20230717","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1111\/j.1600-0404.1996.tb00518.x","article-title":"Myasthenia gravis and primary biliary cirrhosis. Common immunological features and rare coincidence","volume":"93","author":"Kiechl","year":"1996","journal-title":"Acta Neurol Scand."},{"issue":"2","key":"R4-20230717","doi-asserted-by":"crossref","first-page":"151","DOI":"10.3904\/kjim.2000.15.2.151","article-title":"Autoimmune hepatitis in a patient with myasthenia gravis and thymoma\u2014A report on the first case in Korea","volume":"15","author":"Han","year":"2000","journal-title":"Korean J Intern Med."},{"issue":"31","key":"R5-20230717","first-page":"125","article-title":"Coexistence of primary biliary cirrhosis and myasthenia gravis: A case study","volume":"47","author":"Horigome","year":"2000","journal-title":"Hepatogastroenterology"},{"issue":"7","key":"R6-20230717","first-page":"292","article-title":"A patient with thymoma and four different organ-specific autoimmune diseases","volume":"60","author":"Asakawa","year":"2002","journal-title":"Neth J Med."},{"issue":"8","key":"R7-20230717","doi-asserted-by":"crossref","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":"McCann","year":"2004","journal-title":"J Am Geriatr Soc."},{"issue":"4","key":"R8-20230717","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/S1665-2681(19)31627-8","article-title":"Acetylcholine receptor antibody positive generalized myasthenia gravis in association with primary biliary cirrhosis","volume":"9","author":"Taddy","year":"2010","journal-title":"Ann Hepatol."},{"key":"R9-20230717","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1186\/1752-1947-4-356","article-title":"Successful low-dose azathioprine for myasthenia gravis despite hepatopathy from primary sclerosing cholangitis: A case report","volume":"4","author":"Finsterer","year":"2010","journal-title":"J Med Case Rep."},{"issue":"4","key":"R10-20230717","doi-asserted-by":"crossref","first-page":"316","DOI":"10.4103\/0972-2327.91966","article-title":"Coexistence of primary sclerosing cholangitis in a patient with myasthenia gravis","volume":"14","author":"Lorenzoni","year":"2011","journal-title":"Ann Indian Acad Neurol."},{"issue":"2","key":"R11-20230717","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1590\/S0004-282X2012000200019","article-title":"Long-term, low-dose immunosuppression for myasthenia does not affect collateral, asymptomatic sclerosing cholangitis","volume":"70","author":"Finsterer","year":"2012","journal-title":"Arq Neuropsiquiatr."},{"issue":"8","key":"R12-20230717","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1111\/j.1872-034X.2012.00985.x","article-title":"Acute presentation of autoimmune hepatitis in a patient with myasthenia gravis, thymoma, hashimoto thyroiditis and connective tissue disorder","volume":"42","author":"Yapali","year":"2012","journal-title":"Hepatol Res."},{"issue":"10","key":"R13-20230717","doi-asserted-by":"crossref","first-page":"e87","DOI":"10.1097\/JTO.0b013e318298832b","article-title":"Acute autoimmune hepatitis, myositis, and myasthenic crisis in a patient with thymoma","volume":"8","author":"Rajan","year":"2013","journal-title":"J Thorac Oncol."},{"issue":"Suppl 2","key":"R14-20230717","article-title":"Autoimmune hepatitis: An uncommon presentation of thymoma","volume":"102","author":"Mendogni","year":"2016","journal-title":"Tumori"},{"key":"R15-20230717","doi-asserted-by":"crossref","first-page":"20","DOI":"10.4236\/ojcd.2015.51004","article-title":"Autoimmune hepatitis-primary biliary cirrhosis: Overlap syndrome concomitant with unexpected myasthenia and thymoma","volume":"5","author":"Madiha","year":"2015","journal-title":"Open J Clin Diagn."},{"issue":"6","key":"R16-20230717","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/j.cgh.2010.03.004","article-title":"Paris criteria are effective in diagnosis of primary biliary cirrhosis and autoimmune hepatitis overlap syndrome","volume":"8","author":"Kuiper","year":"2010","journal-title":"Clin Gastroenterol Hepatol."},{"key":"R17-20230717","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.jhep.2010.09.002","article-title":"Overlap syndromes: The International Autoimmune Hepatitis Group (IAIHG) position statement on a controversial issue","volume":"54","author":"Boberg","year":"2011","journal-title":"J Hepatol."},{"issue":"3","key":"R18-20230717","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1002\/hep4.1148","article-title":"New Scoring classification for primary biliary cholangitis\u2013autoimmune hepatitis overlap syndrome","volume":"2","author":"Zhang","year":"2018","journal-title":"Hepatol Commun."},{"issue":"1","key":"R19-20230717","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1002\/hep.30145","article-title":"Primary biliary cholangitis: 2018 practice guidance from the American Association for the Study of Liver Diseases","volume":"69","author":"Lindor","year":"2019","journal-title":"Hepatology"},{"key":"R20-20230717","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/0090-1229(87)90033-X","article-title":"Characterization of anti-acetylcholine receptor antibody activity in patients with anti-mitochondria1 antibodies","volume":"45","author":"Sundewall","year":"1987","journal-title":"J Immunol Immunpathol."}],"container-title":["ACG Case Reports Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/02075970-201904000-00006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T13:49:54Z","timestamp":1786542594000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/02075970-201904000-00006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":20,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.14309\/crj.0000000000000026","relation":{},"ISSN":["2326-3253"],"issn-type":[{"value":"2326-3253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4]]}}}