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NEUROLOGY 1996;47:985-987
© 1996 American Academy of Neurology

Intestinal pseudo-obstruction, myasthenia gravis, and thymoma

N. E. Anderson, MB, ChB, D. O. Hutchinson, MB, ChB, G. I. Nicholson, MB, ChB, F. Aitcheson, MB, ChB and J. M. Nixon, MB, ChB

From the departments of Neurology (Drs. Anderson and Hutchinson), Gastroenterology (Dr. Nicholson), and Histopathology (Dr. Nixon), Auckland Hospital and Taupo Hospital (Dr. Aitcheson), Auckland, New Zealand.
Received November 28, 1995. Accepted in final form January 24, 1996.
Address correspondence and reprint requests to Dr. Neil E. Anderson, Department of Neurology, Auckland Hospital, Park Road, Private Bag 92024, Auckland 1, New Zealand.

Two patients presented with abdominal pain, recurrent vomiting, weight loss, and constipation secondary to intestinal pseudo-obstruction. Both patients had symptoms and signs of myasthenia gravis, acetylcholine receptor antibodies, and thymoma. In one patient inflammatory cell infiltrates and occasional degenerate neurons were found in the myenteric plexus. The gastrointestinal symptoms resolved during treatment with pyridostigmine. The close temporal relationship between the onset of the gastrointestinal symptoms and the detection of myasthenia gravis and thymoma suggests that intestinal pseudo-obstruction can be a paraneoplastic syndrome associated with thymoma.

NEUROLOGY 1996;47: 985-987




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