Delay and misdiagnosis in adult myasthenia gravis: A case report
- Author:
Siew Kim Kwa
;
Zainab Abdul Majeed
;
Kah Nian Tan
- Publication Type:Case Reports
- Keywords:
Myasthenia gravis;
misdiagnosis;
delay diagnosis;
late-onset, elderly
- MeSH:
Myasthenia Gravis
- From:International e-Journal of Science, Medicine and Education
2016;10(3):37-39
- CountryMalaysia
- Language:English
-
Abstract:
Myasthenia gravis (MG) is a rare autoimmune disorder
characterised by fluctuating and variable combination
of muscle weakness and fatigue. Most cases are due to
T-cell mediated autoantibodies against post-synaptic
acetylcholine receptors (AChR-Ab), thus preventing
acetylcholine from binding and signalling skeletal
muscle to contract.
1
The annual incidence is 7-23 new cases per million.
1
It can occur at any age but with two peaks; an early-
onset (20-40 years) female-predominant and a late-onset
(60-80 years) male-predominant peak. MG is classified
into ocular and generalised (80%). More than half the
patients initially present with ptosis and diplopia but half
will progress to generalised disease with involvement of
bulbar, limb and respiratory weakness. Those presenting
as generalised MG can also develop eye signs later.
1
It is important to recognise MG early because it is
highly treatable. Untreated disease leads to permanent
weakness.
2
Treatment reduces mortality from life-
threatening myasthenic crisis.
1,3
Misdiagnosis leads to
potentially harmful interventions and inappropriate
management.
4,5
Diagnosis in late-onset MG is easily
missed
2,3,4,5
because of overlapping symptoms with
other diseases common in the elderly. We report a case
of delay and misdiagnosis in an elderly patient with
co-morbidities.
- Full text:P020170120579980268726.pdf
