scholarly journals Myasthenia Gravis Masquerading as Status Asthmaticus

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Neha Pirwani ◽  
Shayna Wrublik ◽  
Shashikanth Ambati
Keyword(s):  
Myasthenia Gravis ◽  
Status Asthmaticus ◽  
Pediatric Population ◽  
Invasive Mechanical Ventilation ◽  
Delayed Diagnosis ◽  
Autoimmune Disorder ◽  
Acute Onset ◽  
Diagnostic Challenge ◽  
Skeletal Musculature ◽  
Juvenile Myasthenia Gravis

Myasthenia gravis, an autoimmune disorder of neuromuscular transmission, can lead to varying degrees of weakness and fatigability of the skeletal musculature. Juvenile myasthenia gravis accounts for 10–15% of all cases of myasthenia gravis. The clinical presentation of juvenile myasthenia gravis varies tremendously, which presents itself as a diagnostic challenge for clinicians. We report a case of a 15-year-old female with mild intermittent asthma presenting with shortness of breath. Acute onset of dyspnea is a common chief complaint amongst the pediatric population with a broad differential diagnosis. Our patient was presumptively treated for status asthmaticus and required invasive mechanical ventilation. After extubating, the patient showed persistent ptosis, which led to the eventual work-up of myasthenia gravis. Upon further review, this patient had months of intermittent symptoms including ptosis and fatigue which went previously undiagnosed. This case demonstrates that dyspnea in an asthmatic can occur from nonairway processes and, if missed, may result in overtreatment of asthma or delayed diagnosis of an important neuromuscular process.

scholarly journals Juvenile Myasthenia Gravis

2018 ◽  
Vol 02 (01) ◽  
pp. E6-E9
Author(s):  
Adela Marina ◽  
Ulrike Schara
Keyword(s):  
Young Children ◽  
Myasthenia Gravis ◽  
Children And Adolescents ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Autoimmune Disorder ◽  
Congenital Myasthenic Syndrome ◽  
Muscular Weakness ◽  
Specific Antibodies ◽  
Juvenile Myasthenia Gravis

AbstractJuvenile myasthenia gravis (JMG) is an autoimmune disorder of neuromuscular transmission caused by production of antibodies against the postsynaptic membrane of the neuromuscular junction. Clinical signs in young children and adolescents range from isolated ocular symptoms to general muscular weakness and respiratory insufficiency. Clinical presentation of JMG in young children and adolescents shows distinct features compared to adults. Young children may show generalized muscular weakness already during the first two years of life, and in this group specific antibodies can be only slightly increased. Because of existing therapeutic options, an early diagnosis is important. In case of negative specific antibodies and onset of the first symptoms during infancy or early childhood, the diagnosis of a congenital myasthenic syndrome (CMS) must be considered and is not always clear to differentiate. Clinical symptoms, diagnostic procedures and therapeutic strategies with consideration of specificities of this age group are discussed.

scholarly journals Juvenile Myasthenia Gravis: A Case Report and Review of Literatures

2013 ◽  
Vol 29 (1) ◽  
pp. 64-69
Author(s):  
Narayan Chandra Kundu ◽  
Moushumi Sen ◽  
KM Nazmul Islam Joy ◽  
Feroj Ahmed Quraish
Keyword(s):  
Myasthenia Gravis ◽  
Antibody Test ◽  
Autoimmune Disorder ◽  
Repetitive Nerve Stimulation ◽  
History Of ◽  
Congenital Myasthenia ◽  
Pediatric Presentation ◽  
Juvenile Myasthenia Gravis ◽  
Ice Pack ◽  
Anti Acetylcholine

Juvenile myasthenia gravis (JMG) is a rare autoimmune disorder of childhood. Pediatric presentation of MG is more common in Oriental than in Caucasian populations. JMG need to be differentiated from congenital myasthenia gravis which do not have haan autoimmune basis. An 11 years old girl presented with drooping of eye lids which was more marked at the later part of day and was gradually progressive . She had complained of double vision. She had no family history of myasthenia gravis. Ice pack test, repetitive nerve stimulation test, and anti acetylcholine receptor antibody test support the diagnosis. She was treated with pyridostigmine and was started as 30mg four times daily and increased to 60 mg/qds. Subsequently her symptoms improved gradually and she became stable. Bangladesh Journal of Neuroscience 2013; Vol. 29 (1) : 64-69

Refractory Ascites as the Only Presenting Symptom of Chronic Calcified Constrictive Pericarditis: A Diagnostic Challenge

2014 ◽  
Vol 17 (1) ◽  
pp. 42
Author(s):  
Shi-Min Yuan
Keyword(s):  
Computed Tomography ◽  
Liver Cirrhosis ◽  
Female Patient ◽  
Constrictive Pericarditis ◽  
Delayed Diagnosis ◽  
Young Female ◽  
Refractory Ascites ◽  
Diagnostic Challenge ◽  
Massive Ascites ◽  
History Of

Extracardiac manifestations of constrictive pericarditis, such as massive ascites and liver cirrhosis, often cover the true situation and lead to a delayed diagnosis. A young female patient was referred to this hospital due to a 4-year history of refractory ascites as the only presenting symptom. A diagnosis of chronic calcified constrictive pericarditis was eventually established based on echocardiography, ultrasonography, and computed tomography. Cardiac catheterization was not performed. Pericardiectomy led to relief of her ascites. Refractory ascites warrants thorough investigation for constrictive pericarditis.

scholarly journals Emergency Department and Radiological Cost of Delayed Diagnosis of Cannabinoid Hyperemesis

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
David I. Zimmer ◽  
Ross McCauley ◽  
Varun Konanki ◽  
Joseph Dynako ◽  
Nuha Zackariya ◽  
...  
Keyword(s):  
Emergency Department ◽  
Delayed Diagnosis ◽  
The United States ◽  
Clinical Syndrome ◽  
Cannabis Use ◽  
Diagnostic Challenge ◽  
High Clinical Suspicion ◽  
Ed Visits ◽  
Inappropriate Utilization ◽  
Utilization Of Healthcare

Background. Chronic cannabis use has become prevalent with decriminalization, medical prescription, and recreational legalization in numerous US states. With this increasing incidence of chronic cannabis use a new clinical syndrome has become apparent in emergency departments and hospitals across the country, termed Cannabinoid Hyperemesis (CH). CH has been described as cyclical vomiting and abdominal pain in the setting of chronic cannabis use, which is often temporarily relieved by hot showers. CH presents a diagnostic challenge to clinicians who do not have a high clinical suspicion for the syndrome and can result in high costs and resource utilization for hospitals and patients. This study investigates the expenditures associated with delayed CH evaluation and delayed diagnosis. Methods. This is a retrospective observational study of 17 patients diagnosed with CH at three medical centers in the United States from 2010 to 2015, consisting of two academic centers and a community hospital. Emergency department (ED) costs were calculated and analyzed for patients eventually diagnosed with CH. Results. For the 17 patients treated, the total cost for combined ED visits and radiologic evaluations was an average of $76,920.92 per patient. On average these patients had 17.9 ED visits before the diagnosis of CH was made. Conclusion. CH provides a diagnostic challenge to clinicians without a high suspicion of the syndrome and may become increasingly prevalent with current trends toward cannabis legalization. The diagnosis of CH can be made primarily through a thorough history and physical examination. Awareness of this syndrome can save institutions money, prevent inappropriate utilization of healthcare resources, and save patients from unnecessary diagnostic tests.

scholarly journals Pancreaticopleural Fistula: A Cause of Recurrent Pleural Effusions in Chronic Pancreatitis

2021 ◽  
Author(s):  
Ayah Megahed ◽  
Rahul Hegde ◽  
Pranav Sharma ◽  
Rahmat Ali ◽  
Anas Bamashmos
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Pleural Fluid ◽  
Rare Complication ◽  
Delayed Diagnosis ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Pleural Effusions ◽  
Diagnostic Challenge ◽  
Abdominal Symptoms ◽  
Pancreatic Duct Stenting

AbstractPancreaticopleural fistula is a rare complication of chronic pancreatitis caused by disruption of the pancreatic duct and fistulous communication with the pleural cavity. It usually presents with respiratory symptoms from recurrent large volume pleural effusions. Paucity of abdominal symptoms makes it a diagnostic challenge, leading often to delayed diagnosis. Marked elevation of pleural fluid amylase, which is not a commonly performed test, is a sensitive marker in its detection. Imaging with magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography can help delineate the fistula. In this report, we present the clinical features, imaging, and management of a 59-year-old male patient with pancreaticopleural fistula, wherein the diagnosis was suspected only after repeated pleural fluid drainages were performed for re-accumulating pleural effusions and it was eventually successfully treated with pancreatic duct stenting. We review the literature with regards to the incidence, presentation, diagnosis, and management of this rare entity.

Juvenile Myasthenia Gravis and Amblyopia

1986 ◽  
Vol 101 (2) ◽  
pp. 214-217 ◽  
Author(s):  
Naomi Ellenhorn ◽  
Neil Lucchese ◽  
Mark Greenwald
Keyword(s):  
Myasthenia Gravis ◽  
Juvenile Myasthenia Gravis

Juvenile Myasthenia gravis

2018 ◽  
Vol 45 (04) ◽  
pp. 283-287
Author(s):  
Adela Della Marina ◽  
Ulrike Schara
Keyword(s):  
Myasthenia Gravis ◽  
Operative Therapie ◽  
Klinische Symptome ◽  
Frühe Diagnosestellung ◽  
Juvenile Myasthenia Gravis ◽  
Diagnostische Möglichkeiten

ZusammenfassungDie autoimmune kindliche und juvenile Myasthenia gravis (JMG) ist bedingt durch die Autoantikörper(Ak)-Bildung gegen die postsynaptische Membran der neuromuskulären Endplatte. Die klinischen Symptome können variabel sein, von der milden okulären Symptomatik bis zu generalisierter Schwäche und respiratorischer Insuffizienz. Die klinische Präsentation und der Verlauf der JMG, insbesondere bei präpubertären Patienten, zeigen Unterschiede im Vergleich zur adulten Form. Eine Manifestation ist schon in den ersten beiden Lebensjahren möglich, in diesem Alter kann der Antikörper-Titer auch bei generalisierten Symptomen nur minimal erhöht sein. Bei den Säuglingen und sehr kleinen Kindern ist bei negativen spezifischen Antikörpern das Vorliegen eines kongenitalen myasthenen Syndroms (CMS) eine wichtige Differenzialdiagnose. Eine frühe Diagnosestellung ist bei bestehenden therapeutischen Möglichkeiten in dieser Patientengruppe wichtig. Wir geben eine Übersicht über klinische Symptome, diagnostische Möglichkeiten sowie medikamentöse und operative Therapie bei Kindern mit JMG.

scholarly journals Thoracoscopic thymectomy for juvenile myasthenia gravis

2019 ◽  
Vol 35 (5) ◽  
pp. 603-610 ◽  
Author(s):  
Aimee G. Kim ◽  
Sydney A. Upah ◽  
John F. Brandsema ◽  
Sabrina W. Yum ◽  
Thane A. Blinman
Keyword(s):  
Myasthenia Gravis ◽  
Juvenile Myasthenia Gravis

scholarly journals Diagnosis of Growing Pain in Bangladeshi Pediatric Population

2013 ◽  
Vol 5 (1) ◽  
pp. 46-48 ◽  
Author(s):  
Santosh Kumar Saha ◽  
Aditi Modak ◽  
Kamrunnahar Chowdhury ◽  
Md Saleh Uddin ◽  
Dilip Kumar Ghosh ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Fever ◽  
Pediatric Population ◽  
Accurate Diagnosis ◽  
Clinical Aspects ◽  
Limb Pain ◽  
Diagnostic Challenge ◽  
Growing Period ◽  
Frequent Site ◽  
Slow Growing

Background: Unexplained limb pain is a major diagnostic challenge. Parents become very much worried as their physician are not sure regarding accurate diagnosis of unexplained limb pain. Majority of the limb pain are due to Growing pain which can be diagnosed by using Standard Criteria. Objectives: The purpose of the present study was to see the clinical aspects of growing pain and to determine the causes of unexplained limb pain. Methodology: This study prospectively examined the presence of growing pain in a self reported population of children with limb pain of unexplained etiology attending National Center for Control of Rheumatic Fever and Heart Disease over the period of 6 months. Results: Total 57 children of 3-12 yrs of age were enrolled in this study and out of them 43(75.4%) were diagnosed as Growing Pain. Mean age of growing pain was 7.77(2.66). 19 children (44.2%) were male and 24 (55.8%) were female. Most frequent site of pain was calf (65.1%) and 95% cases pain occur at night. Growing Pain usually occur at slow growing period (86%) than rapid growing period (14%). Conclusion: Majority of unexplained limb pain are growing pain which is benign. DOI: http://dx.doi.org/10.3329/jssmc.v5i1.16251 J Shaheed Suhrawardy Med Coll, 2013;5(1):46-48

scholarly journals Manajemen Perawatan Neurointensif pada Miastenia Gravis

2021 ◽  
Vol 1 (12) ◽  
pp. 1002-1010
Author(s):  
Dicki Apriansyah Haris Putra ◽  
Lale Sirin Rifdah S ◽  
Putu Mega Asri D ◽  
Muhammad Mahfuzzahroni
Keyword(s):  
Myasthenia Gravis ◽  
Surgical Therapy ◽  
Autoimmune Disorder ◽  
Myasthenic Crisis ◽  
Immunosuppressant Therapy ◽  
Ventilation Non Invasive ◽  
Short Term ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Motor End Plate

Myasthenia gravis (MG) is an autoimmune disorder that affects neuromuscular transmission, causing generalized or localized weakness characterized by fatigue. Myasthenia gravis is most commonly associated with antibodies to the acetylcholine receptor (AChR) on the motor end plate in the postsynaptic neuron. This article aims to determine the appropriate neurointensive management in patients with myasthenia gravis with complications of myasthenic crisis. The writing of this article includes various sources originating from scientific journals and government guidelines and related agencies. Source searches were carried out on online portals for journal publications such as MedScape, Google Scholar (scholar.google.com) and the National Center for Biotechnology Information (ncbi.nlm.nih.gov), with the keyword “Myasthenia Gravis”. The management of myasthenia gravis can be done in various ways, namely, mechanical intubation and ventilation, non-invasive ventilation, pridostigmine as an anticholinesterase inhibitor, immunosuppressant therapy, short term immunotherapy, intravenous immunoglobulin, and surgical therapy. In the treatment of myasthenia gravis, the main goal is to restore muscle condition, especially patient productivity where the management of myasthenia gravis consists of management of myasthenic crisis, cholinergic crisis, symptoms, immunosuppressant therapy, and thymectomy surgical therapy if a tumor is indicated.

Sign in / Sign up

Export Citation Format

Share Document