Case presentation A 54-year-old man developed myalgia and muscle weakness, which aggravated over the last two months. He suffered from myasthenia gravis since the age of 27 years. At 27 and 50 years, he underwent a four-course adjuvant chemotherapy following thymus resection.
He was treated with prednisolone (10 mg, every alternate day) and cyclosporine (70 mg, daily). He also suffered from aplastic anemia for the last four years and has had diabetes for the last 20 years. Physical examination – Normal findings Neurological examination – Cranial nerves intact Dysarthria, ptosis, or dysphagia - Negative Motor examination Strength scores – 3/5 for the bilateral deltoid muscles and 4/5 for the bilateral arm extensor and flexor muscles, hip extensor and flexor muscles, and knee extensor and flexor muscles Deep tendon reflexes – Normal Bilateral Babinski reflexes – Absent Laboratory…
