Candida esophagitis as the cause of swallowing disturbances in an 85-year-old patient with myasthenia gravis.

An 85-year-old man with myasthenia gravis was successfully treated with methotrexate (10 mg/week), pyridostigmine and prednisolone (0-30 mg/day) for over 10 years. Then, he developed dysphagia and lost weight. Gastroscopy revealed Candida esophagitis. The patient received nystatin for 2 weeks. Methotrexate was stopped, and immunosuppressive therapy was continued with prednisolone alone. The patient has now remained in good condition for over 1 year. Although dysphagia is a typical symptom of myasthenia gravis, swallowing disturbances should not be attributed hastily to this disease, since they may also be a complication of therapy.