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Case Report
Myasthenia gravis crisis: A case report
1 DO Class of 2020, Western University of Health Sciences, Lebanon, Oregon, USA
2 DO, MercyOne North Iowa Internal Medicine, Mason City, Iowa, USA
Address correspondence to:
Christine Sykalo
OMS 4, 200 Mullins Dr, Lebanon, Oregon 97355,
USA
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Article ID: 100068Z06CS2019
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How to cite this article
Sykalo C, Adio B, Birchem S. Myasthenia gravis crisis: A case report. Case Rep Int 2019;8:100068Z06CS2019.ABSTRACT
Introduction: Myasthenia gravis (MG) is an autoimmune disease targeting the postsynaptic acetylcholine receptors, which typically presents with fatigue symptoms relieved by rest and is often associated with a thymoma. Myasthenic crisis requires intubation and ventilation, and only 2–3% of MG patients are admitted with crisis per year. Impeding crisis may have a presentation of dyspnea, bulbar symptoms, or both together, requiring immediate attention.
Case Report: We present a seropositive patient without a thymoma, who presented multiple times with dyspnea, which led to anxiety-triggered crisis within minutes. The patient experienced the crisis within two years of being diagnosed with MG, and required intensive care unit (ICU) care for five days, including intravenous immunoglobulin (IVIG) and steroids.
Conclusion: The importance of symptomatic assessment is crucial to avoid and treat myasthenic crisis. Approximately 13–20% of patients, who experience a myasthenic crisis, have it as their initial presentation upon diagnosis, and require ICU care and intubation.
Keywords: Bulbar symptoms, Myasthenia gravis, Myasthenic crisis, Respiratory failure
SUPPORTING INFORMATION
Author Contributions
Christine Sykalo - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Babajide Adio - Substantial contributions to conception and design, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Sandra Birchem - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementVerbal informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2019 Christine Sykalo et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
