Co-occurrence of vitiligo and sweet ageusia in a post- thymectomy Myasthenia Gravis patient in remission: A case report

Abstract

While several journals have published the co-existence of dysgeusia or vitiligo with Myasthenia Gravis (MG), none had described their co-occurrence with MG. Moreover, they usually precede the incidence of weakness, and they disappear several weeks after thymectomy. Here we present a case of a 37-year-old male post-thymectomy patient in remission who initially developed circumscribed depigmentation around the lips and fingers, before consulting us for loss of sweet taste sensation. Aside from elevated Acetylcholine Receptor Antibody (AChR Ab) (6.88 nmol/L; nv: <0.5nnmol/L), other work ups, including a repeat chest CT scan were unremarkable. A low dose prednisone resulted to slight improvement in sweet ageusia one month after initiation. In conclusion, co-occurrence of vitiligo and sweet ageusia may appear in an MG patient in remission even several years after thymectomy. While the decreased immune tolerance may have increased the risk of these non-MG symptoms, thymectomy should still be advocated among MG patients with indication as among the paraneoplastic syndromes associated with thymoma, it has relatively the worst prognosis.