A Myasthenia Gravis case diagnosed simultaneously with diabetic ketoacidosis

Juvenile myasthenia gravis (JMG) is an autoimmune disease caused by antibodies to the postsynaptic membrane at the neuromuscular junction. The association of JMG with Type I diabetes mellitus (DM), another autoimmune disease, is very rare and the pathogenesis has not been fully explained. Our case is the youngest patient where this association has been reported in the literature and presented at the age of 4 years when diabetic ketoacidosis developed together with the emergence of ocular myasthenia findings. She is the only case diagnosed with juvenile myastenia gravis among the 510 type 1 DM patients followed-up at our clinic. Although an autoimmune process may have triggered both autoimmune diseases at the same time in this case, we believe the diabetic ketoacidosis was a triggering factor for the juvenile myasthenia gravis and discuss this association.