01 December 2004
Respiratory failure as a first presentation of myasthenia gravis
Adnan I. Qureshi, Mohammad A. Choudhry, Yousef Mohammad, Hoe C. Chua, Abutaher M. Yahia, John A. Ulatowski, David A. Krendel, Robert T. LeshnerMed Sci Monit 2004; 10(12): CR684-689 :: ID: 13236
Abstract
Background:Although respiratory failure commonly occurs during the course of myasthenia gravis (MG), it is rarely described at presentation in patients with previously unrecognized MG.Material/Methods:We determined the prevalence and clinical characteristics of patients with respiratory failure associated with undiagnosed MG by review of the medical records of all patients who were diagnosed with MG related respiratory failure at four University hospitals. Respiratory failure was defined on the basis of a forced vital capacity Ł1 liter, negative inspiratory force Ł20 cm H2O, or requirement of mechanical ventilation.Results:Out of 51 MG patients with respiratory failure, 7(14%) patients had no previous diagnosis of MG. Another patient was identified after the review. The mean age of these 8 patients was 56 years (range 23–76 years); six were women. Five had previous episodes of unexplained respiratory failure. On initial evaluation, ocular or bulbar signs were present in 7 patients. The diagnosis of MG was made by edrophonium test (n=3), edrophonium test with positive acetylcholine antibody levels or repetitive nerve stimulation (n=2), repetitive nerve stimulation with positive acetylcholine antibody levels (n=2), and positive acetylcholine antibody levels alone (n=1). Seven patients required mechanical ventilation. Plasma exchange (n=7) or intravenous immunoglobulins (n=1) resulted in successful extubation or resolution of symptoms in all patients.Conclusions:Respiratory failure can occur at presentation in MG. A high index of suspicion should be maintained in patients with previous history of unexplained respiratory failures.
Keywords: Myasthenia Gravis - diagnosis, Respiratory Insufficiency - diagnosis, Myasthenia Gravis - diagnosis, Respiratory Insufficiency - diagnosis
Editorial
01 January 2023 : Editorial
Editorial: Current Status of Two Adjuvanted Malaria Vaccines and the World Health Organization (WHO) Strategy to Eradicate Malaria by 2030DOI: 10.12659/MSM.939357
Med Sci Monit 2023; 29:e939357
SARS-CoV-2/COVID-19
26 January 2023 : Editorial
Editorial: The XBB.1.5 (‘Kraken’) Subvariant of Omicron SARS-CoV-2 and its Rapid Global SpreadMed Sci Monit In Press; DOI: 10.12659/MSM.939580
19 January 2023 : Clinical Research
Evaluation of Health-Related Quality of Life and Mental Health in 729 Medical Students in Indonesia During ...Med Sci Monit In Press; DOI: 10.12659/MSM.938892
19 January 2023 : Clinical Research
Determining the Impact of the COVID-19 Pandemic on Dental Care in the Serbian Adult Population: An Online Q...Med Sci Monit 2023; 29:e939238
27 December 2022 : Clinical Research
Effect of Physiotherapy to Correct Rounded Shoulder Posture in 30 Patients During the COVID-19 Pandemic in ...Med Sci Monit 2022; 28:e938926
In Press
27 Jan 2023 : Database Analysis
Association Between Neutrophil-Lymphocyte Ratio and All-Cause Mortality in Critically Ill Patients with Chr...Med Sci Monit In Press; DOI: 10.12659/MSM.938554
27 Jan 2023 : Clinical Research
Proposal for a Simple Equation for Limb Muscle Weight CalculationMed Sci Monit In Press; DOI: 10.12659/MSM.938606
26 Jan 2023 : Editorial
Editorial: The XBB.1.5 (‘Kraken’) Subvariant of Omicron SARS-CoV-2 and its Rapid Global SpreadMed Sci Monit In Press; DOI: 10.12659/MSM.939580
20 Jan 2023 : Clinical Research
A Study of 42 Partially Edentulous Patients with Single-Crown Restorations and Implants to Compare Bone Los...Med Sci Monit In Press; DOI: 10.12659/MSM.939225
Most Viewed Current Articles
13 Nov 2021 : Clinical Research
Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...DOI :10.12659/MSM.932788
Med Sci Monit 2021; 27:e932788
30 Dec 2021 : Clinical Research
Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...DOI :10.12659/MSM.935379
Med Sci Monit 2021; 27:e935379
08 Mar 2022 : Review article
A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...DOI :10.12659/MSM.936292
Med Sci Monit 2022; 28:e936292
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952