A neuro-immunological cocktail

This report describes the story of a young female, diagnosed with the rare combination dermatomyositis and myasthenia gravis (MG). The patient presented with progressive muscle weakness without typical skin manifestations of dermatomyositis, except for an early mechanic's hand. In addition, the patient had fatiguability and mild ptosis which raised the suspicion of MG which was later confirmed by the presence of anti-acetyl choline receptor antibodies and clinical response to pyridostigmine. On evaluation, she was found to be seropositive for Mi-2Beta antibody, which is a myositis-specific antigen for classical steroid responsive dermatomyositis. The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice based learning and improvement.