STIFF-MAN SYNDROME-ASSOCIATED WITH ANTECEDENT MYASTHENIA-GRAVIS AND ORGAN-SPECIFIC AUTOIMMUNOPATHY

We describe a case of stiff-man syndrome accompanied by diabetes melli tus, Hashimoto's thyroiditis and the antecedent myasthenia gravis. The diagnosis of stiff-man syndrome was made based on not only clinical f indings and the characteristic electromyographic pattern but also the presence of antibodies to glutamic acid decarboxylase in the serum and cerebrospinal fluid, Stiff-man syndrome is known to be associated wit h organ-specific autoimmunopathy including insulin-dependent diabetes mellitus, The present case is the first one that stiff-man syndrome wa s preceded by myasthenia gravis of organ-specific autoimmunopathy, Sti ff-man syndrome in the present case probably represents the one of ful ly expressed manifestations from the broad spectrum of organ-specific autoimmunopathy caused by the loss of self-tolerance.