Myasthenia gravis masquerading as amyotrophic lateral sclerosis: a case report.
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Date
2023
Authors
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Volume Title
Publisher
Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Miasthenia gravis, jeb miastēnija ir autoimūna slimība, kas izraisa skeleta muskulatūras vājumu. To uzskata par salīdzinoši retu slimību. Visbiežāk pirmie simptomi ir saistīti ar acs muskuļu vājumu, kas var rezultēties ar ptozi un/vai diplopiju, var progresēt fiziskas slodzes laikā un mazināties pēc atpūtas. Tomēr miastēnija var skart jebkuru skeleta muskulatūras grupu, kas rezultējas ar klīnisko simptomu variabilitāti un potenciālam grūtībām slimības diagnostikā. Mēs prezentējam gadījuma aprakstu par 62 gadus vecu vīrieti, kam slimība sākotnēji manifestējās ar bulbāru simptomātiku un netīšu svara zudumu, atipisku atradni elektromiogrāfijas izmeklējumā (dekrementa amplifikācijas iztrūkums kombinācijā ar spontānu muskuļu aktivitāti) – kas ir raksturīgs amiotrofai laterālai sklerozei (ALS). Pēc rūpīgas izmeklēšanas ALS diagnoze netika apstiprināta, taču bija aizdomas par miastēnijas diagnozi. Pacientam tika nozīmēts Piridostigmīns, Prednizolons, kā arī pacientam tika veikta plazmaferēze, kas būtiski uzlaboja pacienta stāvokli.
Myasthenia gravis is an autoimmune disease that causes weakness in the skeletal muscles. It is considered to be a relatively rare disease. Most commonly the first symptoms are associated with ocular muscle weakness resulting in ptosis and/or diplopia that may be progressive during the periods of muscle exertion and resolve with rest. However, any skeletal muscle group may be affected leading to the variability of clinical symptoms and potential challenges in diagnostics. We present a case report of a 62-year-old male that initially presented with bulbar symptoms and unintentional weight loss, with atypical findings in electromyography study (the absence of decrement amplification in a combination of spontaneous muscular activity) – suggestive for amyotrophic lateral sclerosis (ALS) diagnosis. After a thorough investigation the diagnosis of ALS was not confirmed but myasthenia gravis was highly suspected. The patient was prescribed Pyridostigmine, Prednisolone and underwent plasmapheresis procedure which led to significant relief of the symptoms.
Myasthenia gravis is an autoimmune disease that causes weakness in the skeletal muscles. It is considered to be a relatively rare disease. Most commonly the first symptoms are associated with ocular muscle weakness resulting in ptosis and/or diplopia that may be progressive during the periods of muscle exertion and resolve with rest. However, any skeletal muscle group may be affected leading to the variability of clinical symptoms and potential challenges in diagnostics. We present a case report of a 62-year-old male that initially presented with bulbar symptoms and unintentional weight loss, with atypical findings in electromyography study (the absence of decrement amplification in a combination of spontaneous muscular activity) – suggestive for amyotrophic lateral sclerosis (ALS) diagnosis. After a thorough investigation the diagnosis of ALS was not confirmed but myasthenia gravis was highly suspected. The patient was prescribed Pyridostigmine, Prednisolone and underwent plasmapheresis procedure which led to significant relief of the symptoms.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Miastēnija, Amiotrofā laterālā skleroze, Autoantivielas, Autoimūns, Myasthenia gravis, Anti-muscle-specific tyrosine kinase, Amyotrophic lateral sclerosis, Autoantibodies, Autoimmune