Myasthenic Crisis Complicated with Myxedema, Positive for Both Anti-acetylcholine Receptor and Anti-muscle-specific Tyrosine Kinase Antibodies

Intern Med. 2018 Jan 15;57(2):265-268. doi: 10.2169/internalmedicine.9291-17. Epub 2017 Nov 1.

Abstract

We herein report the case of myasthenic crisis occurring in a 51-year-old man. He had experienced ptosis, increased body weight with edema, and fatigue with dyspnea. He presented at our emergency department with disturbed consciousness. He was originally diagnosed with myxedema coma, and he required artificial respiration. Because his weakness persisted and he was positive for anti-acetylcholine receptor antibodies and anti-muscle-specific tyrosine kinase antibodies, we diagnosed myasthenic crisis after various examinations. His clinical response to treatment was good and he was discharged in an ambulatory status 3 months after admission. This case demonstrates that myasthenic crisis may occur in association with myxedema.

Keywords: anti-acetylcholine receptor antibody; anti-muscle-specific tyrosine kinase antibody; myasthenia gravis; myasthenic crisis; myxedema coma.

Publication types

  • Case Reports

MeSH terms

  • Autoantibodies / immunology
  • Humans
  • Male
  • Middle Aged
  • Myasthenia Gravis / complications*
  • Myasthenia Gravis / therapy
  • Myxedema / complications*
  • Myxedema / therapy
  • Protein-Tyrosine Kinases / immunology*
  • Receptors, Cholinergic / immunology*
  • Respiration, Artificial / adverse effects

Substances

  • Autoantibodies
  • Receptors, Cholinergic
  • Protein-Tyrosine Kinases