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THE ASSOCIATION OF AUTOIMMUNE, HORMONAL AND PARANEOPLASTIC FACTORS IN MYASTHENIA WITH GIGANTOMASTIA


DOI: http://dx.doi.org/10.18821/1560-9545-2017-22-1-25-32

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Abstract

The exact etiology and pathogenesis of gigantomastia (GM) are still unknown. The main hypothesizes highlights the leading role of sex hormones. Earlier proposed classification was worked out according etiology factor (puberty-induced, pregnancy-induced, idiopathic and drug-induced) setting aside autoimmune factor. The article presents eight case reports of women with gigantomastia associated with autoimmune myasthenia and other autoimmune diseases, paraneoplastic processes and hormonal factors. These conditions are not considered as a random coincidence, there is possible pathogenic relationship of such seemingly different pathologic processes. All of our patients with myasthenia and puberty-induced GM had a familial history of GM, and in half of them the onset of myasthenia, menarhe and excessive breast growth coincided in time. In one case pregnancy induced both recurrence of GM and manifestation of myasthenia gravis. In another case pregnancy induced the breast enlargement in a woman suffering from myasthenia for last two years. The combination of drug-induced GM and myasthenia was observed in three women: two of them had an ovarian dysfunction and received combined oral contraceptive and herbal estrogen-like medicine respectively, and the third woman was treated with cyclosporine A because of refractory myasthenia. In one case of idiopathic GM excessive breast growth preceded myasthenia development within three years. Some years later in this woman systemic lupus erythematosus and bronchial asthma developed and myasthenia gravis manifested in her younger sister, who had recurrent breast fibroadenoma. In seven patients there was a family history of autoimmune disease or cancer. We report a unique case of association of ocular myasthenia, puberty-induced GM and opsoclonus-myoclonus syndrome. Thus, the presented cases demonstrate a close engagement of immune, hormonal, paraneoplastic and genetic factors in pathogenesis of myasthenia gravis, associated with GM.


Для цитирования: Щербакова Н.И., Хрущева Н.А., Антонова К.В., Галкина О.И., Шабалина А.А., Костырева М.В., Шведков В.В. Сочетание миастении и гигантомастии: тесное переплетение аутоиммунных, гормональных и паранеопластических факторов. Неврологический журнал. 2017; 22 (1): 25–32 (Russian). DOI: http://dx.doi.org/10.18821/1560-9545-2017-22-1-25-32

For citation: Shcherbakova N.I., Khrushcheva N.A., Antonova K.V., Galkina O.I., Shabalina A.A., Kostyreva M.V., Shvedkov V.V. The Association Of Autoimmune, Hormonal And Paraneoplastic Factors In Myasthenia With Gigantomastia. Nevrologicheskiy zhurnal (The Neurological Journal) 2017; 22 (1): 25–32 (Russian). DOI: http://dx.doi.org/10.18821/1560-9545-2017-22-1-25-32

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ISSN: 1560-9545 (Print)
ISSN: (Online)