Coexistent Myasthenia Gravis and Hypopituitarism

To the Editor.— We recently encountered a patient with coexistent myasthenia gravis and hypopituitarism. To our knowledge, this association has not previously been reported, and we suggest that their occurrence in our patient may have been related to an underlying autoimmune disorder. Myasthenia gravis has been reported to occur in association with Hashimoto thyroiditis, rheumatoid arthritis, pernicious anemia, systemic lupus erythematosus, Sjogren disease, and polymyositis 1-4 —suggesting an underlying autoimmune process. In this regard, it is also interesting to note that an animal model of myasthenia gravis has recently been experimentally produced by the injection of acetylcholine receptor in rabbits. 5 Hypopituitarism has previously been reported to occur on an autoimmune basis, 6,7 and, recently, allergic hypophysitis 8 has been experimentally produced in rats, lending support to the earlier clinical observations. Report of a Case.— This 39-year-old man was in good health until January 1969, when transient diplopia developed, lasting