단일 급발성 고탄산 호흡부전으로 발현한 중증근무력증
Myasthenia Gravis Presenting as Sudden–onset Isolated Hypercapnic Respiratory Failure
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Myasthenic crisis, which can be life-threatening due to severe respiratory failure, occurs in 15-20% of patients with myasthenia gravis. However, the crisis often develops within 1-2 years after diagnosis and is very rare as a first symptom of myasthenia gravis; isolated sudden-onset hypercapnic respiratory failure without other symptoms of myasthenia gravis is even rarer. A 63-year-old woman presented to the emergency department with fever and dizziness. Chest computed tomography showed multifocal peribronchial ground-glass opacities, and a diagnosis of pneumonia was made. Initially, the patient did not have dyspnea. However, she developed acute hypercapnic respiratory failure and was intubated. After mechanical ventilation, her hypercapnia improved initially, but worsened on initiation of weaning from the ventilator. As she had a high acetylcholine receptor antibody titer, myasthenia gravis was diagnosed. Her hypercapnia improved after treatment with pyridostigmine and methylprednisolone.
Abstract
Myasthenic crisis, which can be life-threatening due to severe respiratory failure, occurs in 15-20% of patients with myasthenia gravis. However, the crisis often develops within 1-2 years after diagnosis and is very rare as a first symptom of myasthenia gravis; isolated sudden-onset hypercapnic respiratory failure without other symptoms of myasthenia gravis is even rarer. A 63-year-old woman presented to the emergency department with fever and dizziness. Chest computed tomography showed multifocal peribronchial ground-glass opacities, and a diagnosis of pneumonia was made. Initially, the patient did not have dyspnea. However, she developed acute hypercapnic respiratory failure and was intubated. After mechanical ventilation, her hypercapnia improved initially, but worsened on initiation of weaning from the ventilator. As she had a high acetylcholine receptor antibody titer, myasthenia gravis was diagnosed. Her hypercapnia improved after treatment with pyridostigmine and methylprednisolone.
참고문헌 (9)
- Bubuioc AM, "The epidemiology of myasthenia gravis", J Med Life, 14, pp.7~16 (2021)
- Salari N, "Global prevalence of myasthenia gravis and the effectiveness of common drugs in its treatment : a systematic review and meta-analysis", J Transl Med, 19, pp.516~ (2021)
- Estephan EP, "Myasthenia gravis in clinical practice", Arq Neuropsiquiatr, 80(Suppl 1), pp.257~265 (2022)
- Wendell LC, "Myasthenic crisis", Neurohospitalist, 1, pp.16~22 (2011)
- Dushay KM, "Myasthenia gravis presenting as isolated respiratory failure", Chest, 97, pp.232~234 (1990)
- Mier A, "Unsuspected myasthenia gravis presenting as respiratory failure", Thorax, 45, pp.422~423 (1990)
- Qureshi AI, "Respiratory failure as a first presentation of myasthenia gravis", Med Sci Monit, 10, pp.CR684~CR689 (2004)
- Neumann B, "Myasthenic crisis demanding mechanical ventilation : a multicenter analysis of 250 cases", Neurology, 94, pp.e299~e313 (2020)
- Binks S, "Myasthenia gravis : a clinical-immunological update", J Neurol, 263, pp.826~834 (2016)