Case of Myasthenia Gravis Admitted With Complaints of Difficulty Swallowing

Yıl 2019, Cilt: 1 Sayı: 2, 89 - 90, 03.09.2019

Tuba Ekmekyapar Şükrü Gürbüz , Muhammed Ekmekyapar , Hakan Oğuztürk Alper Demirkaya

Öz

Myasthenia gravis (MG) is a neuromuscular autoimmune
disease that occurs with antibody development against nicotinic acetylcholine
receptors. The 19-year-old female patient was admitted to the
emergency service with the complaint of difficulty in swallowing for 1 week.
There was no history of abnormality in the patient. The uvula sola was deviated
in the physical examination of the patient. The obtained brain, cervical and
thorax CT and the diffusion MRI of the patient were normal. Consultation was
requested for the patient from neurology, and the patient was hospitalized at
the neurology clinic with the pre-diagnosis of myasthenia gravis. The case that acutely occurs in myasthenic patients
and is characterized by severe loss of strength and respiratory deficiency is
known as myasthenic crisis (MC). The diagnosis of MC must be confirmed by
considering the patient’s history and signs of physical and neurological signs.
Myasthenia
gravis is an autoimmune disease that is concerned with the neuromuscular
junction, and it may lack a diagnosis in the initial periods. We should include
myasthenia gravis as a pre-diagnosis in patients with difficulty in swallowing
that are admitted to emergency services as a result of upper respiratory
infections such as acute pharyngitis and acute tonsillitis.

Anahtar Kelimeler

Uvula deviation, emergency medicine, myasthenia gravis

Kaynakça

• 1. Sieb JP. Myasthenia gravis: an update for the clinician. Clin Exp Immunol 2014; 175: 408-18.
• 2. Erdal H, Ozyurt Y, Arıkan Z. Myastenia gravis ve anestezi: olgu sunumu. Bakırkoy Tıp Dergisi 2006; 2: 141-3.
• 3. Spillane J, Higham E, Kullmann DM. Myasthenia gravis. BMJ 2012; 345:e8497.
• 4. Bedlack RS, Sanders DB. How to handle myasthenic crisis. Essential steps in patient care. Postgrad Med 2000; 107: 211-4.
• 5. Mishra SK, Krishnappa S, Bhat RR, Badhe A. Role of intermittent noninvasiv eventilation in anticholinesterase dose adjustment for myasthenic crisis. Acta Anaesthesiol Taiwan 2010; 48:53-4.
• 6. Piastra M, Conti G, Caresta E, Tempera A, Chiaret-ti A, Polidori G, et al. Noninvasive ventilation options in pediatric myasthenia gravis. Paediatr Ana-esth 2005; 15:699-702.