We present a case of aged married couple with generalized myasthenia gravis (MG). Clinical diagnosis was supported by EMG findings and evidence of antibody production against acetylcholin receptors.
Myasthenia gravis clinically manifested several weeks after vaccination against influenza and subsequent viral infection with fever in both patients. The failure of immune tolerance and the development of organ-specific autoimmune disease emerged in polymorbid individuals.
We assume that both patients developed MG on the ground of pre-existing disorders of the immune system (hypothyroidism). Iatrogenic (immunization) or viral infection resulted in the stimulation of the immune defense response which led to the deregulation of immune tolerance and clinical manifestations of MG.
Noticeable is the close relation between the immunization, viral infection and development of the symptoms in both individuals.