Myasthenia gravis with acute respiratory failure in the emergency department

Hasan Huseyin Kozak; Ali Ulvi Uca; Turgut Teke; Mustafa Altas; Emine Karatas

doi:10.1016/j.tjem.2015.03.002

Hasan Huseyin Kozak¹, Ali Ulvi Uca¹, Turgut Teke², Mustafa Altas¹, Emine Karatas²

¹Necmettin Erbakan University, Meram Faculty of Medicine, Department of Neurology, Turkey
²Necmettin Erbakan University, Meram Faculty of Medicine, Department of Chest Disease, Konya, Turkey

Keywords: Acute respiratory failure; Myasthenia graves; Emergency medicine

Abstract

Acute respiratory failure (ARF) is defined as a sudden malfunction in the ability of respiratory system to maintain adequate gas exchange. Acute hypercapnic respiratory failure develops as a result of ventilation deficiency and it is defined as an increase of PaCO2 above 45 mmHg. Myasthenia Gravis (MG) is a sporadically developing auto-immune deficiency where the neuro-muscular transmission is affected and it is one of the important reasons for neurologically-induced respiratory distress. Here, we report a case of a 75-year-old male patient previously undiagnosed MG, who presented with ARF. MG is not a common entity that we encounter daily. Patients on occasions may present to the emergency department because of acute exacerbation. Though most of them were known cases, we should be aware of some unrecognized cases and should consider MG as a differential diagnosis for patients with acute respiratory failure.