Akut SolunumYetmezliğinin Nadir Bir Nedeni: Myastenia Gravis

Abstract

Miyastenia gravis, iskelet kaslarında güçsüzlük ve çabuk yorulma ile karakterize bir kas hastalığıdır. Genellikle yakınma kas güçsüzlüğü olsa da bizim olgumuzda olduğu gibi solunum yetmezliği olarak da ortaya çıkabilir. MG, Asetilkolin-esteraz (AChE) inhibitörleri veya immune süpresanlar gibi ilaçlarla ve seçilmiş vakalarda timektomiyle tedavi edilir. Biz burada acil servise solunum yetmezliği ve yutma güçlüğü ile başvuran, MG'li 72 yaşında bir erkek hastayı sunuyoruz.  

Keywords

• Akut solunum yetmezliği; miyastenia gravis; miyastenik kriz.

A Rare Cause of Acute Respiratory Failure: Myastenia Gravis

Abstract

Myasthenia gravis (MG) which is an autoimmune disorder, characterized by fluctuating weakness and rapid fatigue in the skeletal muscles. The usual initial complaint is a muscle weakness but can also present as respiratory failure, as in our case. MG is treated with medications such as Acetylcholine-esterase (AChE) inhibitors or immunosuppressants and in selected cases, thymectomy. Here, we present a case of 72 year old male with MG, who admitted to emergency department with respiratory failure and difficulty in swallowing.  

Keywords

• Acute respiratory failure; myasthenia gravis; myasthenic crisis

References

1. 1. Godoy DA, Mello LJVd, Masotti L, Napoli MD. The myasthenic patient in crisis: an update of the management in Neurointensive Care Unit. Arq Neuropsiquiatr 2013; 71(9): 627-39.
2. 2. Ropper A, Gress D, Diringer M, Green D, Mayer S, Bleck T. Treatment of the critically ill patient with myasthenia gravis. Neurological and Neurosurgical Intensive Care 2004: 299-311.
3. 3. Singh P, Idowu O, Malik I, Nates JL. Acute respiratory failure induced by magnesium replacement in a 62-year-old woman with myasthenia gravis. Tex Heart Inst J 2015; 42(5): 495-7.
4. 4. Bedlack RS, Sanders DB. On the concept of myasthenic crisis. J Clin Neuromuscul Dis 2002; 4(1): 40-2.
5. 5. Tintinalli JE. Fluoroquinolones should be avoided in myasthenia gravis. Ann Emerg Med 2004; 44(1): 87-8.
6. 6. Provencio JJ, Bleck TP, Connors Jr AF. Critical care neurology. Am J Respir Crit Care Med 2001; 164(3): 341-5.
7. 7. Spillane J, Hirsch N, Kullmann D, Howard R. 170 Diaphragmatic weakness following thymectomy: due to myasthenia gravis or phrenic nerve injury? J Neurol Neurosurg Psychiatry 2012; 83(3): 1.
8. 8. Gilhus NE, Verschuuren JJ. Myasthenia gravis: subgroup classification and therapeutic strategies. The Lancet Neurology 2015; 14(10): 1023-36.