{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:19:07Z","timestamp":1767676747419},"reference-count":12,"publisher":"Scientific Scholar","issue":"01","license":[{"start":{"date-parts":[[2019,9,2]],"date-time":"2019-09-02T00:00:00Z","timestamp":1567382400000},"content-version":"vor","delay-in-days":244,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Neurosciences in Rural Practice"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>The unique association of myasthenia gravis (MG) with Graves' disease in clinical practice emphasizes that one autoimmune disease can coexist with another or many. The relationship between these two entities has remained controversial till date. Some authors have reported a see-saw relationship between these two entities, MG waning with hyperthyroidism and waxing with treatment of hyperthyroidism. Treatment of both these disorders concurrently may be challenging at times as treatment for one entity may worsen the other. The use of beta-blockers and steroids for Graves' disease may worsen myasthenic weakness. Antithyroid drugs can worsen myasthenia probably by immunomodulatory effects. We report a case of Graves' disease coexisting with MG in a reciprocal relationship which was subsequently reversed after immunotherapy.<\/jats:p>","DOI":"10.4103\/jnrp.jnrp_150_18","type":"journal-article","created":{"date-parts":[[2019,1,8]],"date-time":"2019-01-08T07:54:51Z","timestamp":1546934091000},"page":"136-138","source":"Crossref","is-referenced-by-count":5,"title":["See-Saw Relationship and its Reversal after Immunotherapy in a Case of Graves\u2019 Disease with Coexisting Myasthenia Gravis"],"prefix":"10.25259","volume":"10","author":[{"given":"Sathish Kumar","family":"Mallikarjuna","sequence":"additional","affiliation":[{"name":"Department of Neurology, Stanley Medical College, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. Sakthi","family":"Velayutham","sequence":"additional","affiliation":[{"name":"Department of Neurology, Stanley Medical College, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. R.","family":"Sowmini","sequence":"additional","affiliation":[{"name":"Department of Neurology, Stanley Medical College, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malcolm K.","family":"Jeyaraj","sequence":"additional","affiliation":[{"name":"Department of Neurology, Stanley Medical College, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Arunan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Stanley Medical College, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2019,9,2]]},"reference":[{"key":"key-10.4103\/0976-3147.249357-1","first-page":"2","volume-title":"Myasthenia gravis associated with Graves' disease in Japan","author":"Ohno","year":"1987","journal-title":"Jpn J Med"},{"key":"key-10.4103\/0976-3147.249357-2","first-page":"842","volume-title":"The relationship to hyperthyroidism to myasthenia gravis","author":"McEachern","year":"1948","journal-title":"J Clin Endocrinol Metab"},{"key":"key-10.4103\/0976-3147.249357-3","first-page":"950","volume-title":"See-saw relationship between hyperthyroidism and myasthenia gravis","author":"Maclean","year":"1954","journal-title":"Lancet"},{"key":"key-10.4103\/0976-3147.249357-4","first-page":"762","volume-title":"Relation between myasthenia gravis and thyroid disease","author":"Sahay","year":"1965","journal-title":"Br Med J"},{"key":"key-10.4103\/0976-3147.249357-5","first-page":"43","volume-title":"Reverse 'see-saw' relationship between Graves' disease and myasthenia gravis; clinical and immunological studies","author":"Sekiguchi","year":"2005","journal-title":"J Med Dent Sci"},{"key":"key-10.4103\/0976-3147.249357-6","first-page":"4","volume-title":"Grave's disease associated with myasthenia gravis: a case report","author":"Apouye","year":"2014","journal-title":"Intern Med Inside"},{"key":"key-10.4103\/0976-3147.249357-7","unstructured":"Jameson L, Kasper D, Hauser S, Longo D, Fauci A, Loscalzo J. Harrison's Principles of Internal Medicine. Myasthenia Gravis and Other Disorders of Neuromuscular Disorder. 19th ed., Ch. 461. Newyork City: McGraw-Hill Publishing Company; 2015. p. 2701."},{"key":"key-10.4103\/0976-3147.249357-8","first-page":"5","volume-title":"The thyroid gland in relation to neuromuscular disease","author":"Millikan","year":"1953","journal-title":"AMA Arch Intern Med"},{"key":"key-10.4103\/0976-3147.249357-9","first-page":"280","volume-title":"Effect of orally administered antithyroid thioureylenes on PCNA and P53 expression in psoriatic lesions","author":"Elias","year":"1995","journal-title":"Int J Dermatol"},{"key":"key-10.4103\/0976-3147.249357-10","first-page":"729","volume-title":"Prednisone-induced worsening of neuromuscular function in myasthenia gravis","author":"Miller","year":"1986","journal-title":"Neurology"},{"key":"key-10.4103\/0976-3147.249357-11","first-page":"834","volume-title":"Letter: Beta-blockers and myasthenia gravis","author":"Herishanu","year":"1975","journal-title":"Ann Intern Med"},{"key":"key-10.4103\/0976-3147.249357-12","doi-asserted-by":"crossref","unstructured":"Sehgal S, Rebello R, Wolmarans L, Elston M. Hickam's dictum: Myasthenia gravis presenting concurrently with Graves' disease. BMJ Case Rep 2017;2017. pii: bcr-2017-220153.","DOI":"10.1136\/bcr-2017-220153"}],"container-title":["Journal of Neurosciences in Rural Practice"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.4103\/jnrp.jnrp_150_18.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,5]],"date-time":"2023-08-05T04:16:42Z","timestamp":1691209002000},"score":1,"resource":{"primary":{"URL":"https:\/\/ruralneuropractice.com\/see-saw-relationship-and-its-reversal-after-immunotherapy-in-a-case-of-graves-disease-with-coexisting-myasthenia-gravis\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1]]},"references-count":12,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2019,9,2]]},"published-print":{"date-parts":[[2019,1]]}},"URL":"https:\/\/doi.org\/10.4103\/jnrp.jnrp_150_18","relation":{},"ISSN":["0976-3147","0976-3155"],"issn-type":[{"value":"0976-3147","type":"print"},{"value":"0976-3155","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1]]}}}