Delay in diagnosis in life-threatening Myasthenia Gravis

Marta M. Morell-Castro, Pulmonary & Critical Care Service, Veterans Hospital San Juan, Puerto Rico
Juan Irizarry-Nieves, Pulmonary & Critical Care Service, Veterans Hospital San Juan, Puerto Rico
Delva Rivera-Chacon, Pulmonary & Critical Care Service, Veterans Hospital San Juan, Puerto Rico
William Rodríguez-Cintrón, Pulmonary & Critical Care Service, Veterans Hospital San Juan, Puerto Rico

Myasthenia gravis (MG) is a rare autoimmune disorder characterized by antibodies against acetylcholine receptors leading to weakness in respiratory muscles. Underlying cardiac disease may increase the risk of prolonged mechanical ventilation. A 76-year-old male is admitted to the intensive care unit with Hypercapnic respiratory failure secondary to volume overload. Despite treatment there was no improvement in respiratory failure requiring mechanical ventilation, which warranted investigation for causes of hypercapnic respiratory failure. The diagnosis of MG was confirmed by the presence of acetylcholine receptor binding antibodies. The delay in diagnosis and treatment lead to multiple complications leading to prolonged hospital stay

Keywords: Myasthenia gravis. Hypercapnic respiratory failure. Respiratory failure. Neuromuscular disorder. Myasthenia Crisis.