GOITER WITH ASSOCIATED MYASTHENIA GRAVIS

Abstract

Exophthalmic goiter with associated myasthenia is common, but exophthalmic goiter accompanied by myasthenia gravis of the bulbar type is rare. The first case of the association of these two diseases was reported by Rennie in 1908.¹ Ten additional cases of exophthalmic goiter and 1 case of adenomatous goiter with hyperthyroidism, all with myasthenia gravis, have been found recorded in the literature.² To this group we wish to add 3 more cases of exophthalmic goiter and 1 case of adenomatous goiter with hyperthyroidism combined with myasthenia gravis. In 1 of our cases subtotal thyroidectomy was performed successfully, with alleviation of symptoms of both diseases. REPORT OF CASES Case 1. —A married woman aged 39 registered at the Mayo Clinic in November 1939. She complained of difficult speech of eleven days' duration and double vision of four days' duration. In 1933 her systolic blood pressure had been found to be