Selective Type 2 Respiratory Failure Followed by Ocular Myasthenia Gravis Diagnosed by Ice Pack Test: A Case Report

Myasthenia gravis is an autoimmune neuromuscular disorder that can present with skeletal muscle involvement, ocular muscles involvement and can progress to respiratory muscle paralysis. Here, we present a unique case of type 2 respiratory failure due to myasthenia gravis with the delayed ocular pres...

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Published in:Curēus (Palo Alto, CA) CA), 2019-06, Vol.11 (6), p.e4927
Main Authors: Dave, Hitanshu, Desai, Rupak, Checker, Sanggita, Yagnik, Priyank J
Format: Article
Language:English
Subjects:
Blood gas analysis
Case reports
Electromyography
Enzymes
Immunoassay
Immunoglobulins
Internal Medicine
Laboratories
Medical diagnosis
Ophthalmology
Pulmonary arteries
Pulmonology
Respiratory failure
Thromboembolism
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Desai, Rupak
Checker, Sanggita
Yagnik, Priyank J
description Myasthenia gravis is an autoimmune neuromuscular disorder that can present with skeletal muscle involvement, ocular muscles involvement and can progress to respiratory muscle paralysis. Here, we present a unique case of type 2 respiratory failure due to myasthenia gravis with the delayed ocular presentation. A 46-year-old female patient presented to the outpatient clinic with complaints of dyspnea. On further evaluation, she was found to be hypercapnic on arterial blood gas analysis with no muscular weakness in any of the limbs. The patient further progressed to ocular symptoms. With the use of an ice pack test, a bedside test for improvement of ptosis, the patient was diagnosed with myasthenic ptosis preventing further progression of type 2 respiratory failure and intubation. With this case report, we emphasize the critical role of such simple bedside test in timely diagnosis and management of myasthenia gravis while awaiting the final results.
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subjects Blood gas analysis
Case reports
Electromyography
Enzymes
Immunoassay
Immunoglobulins
Internal Medicine
Laboratories
Medical diagnosis
Ophthalmology
Pulmonary arteries
Pulmonology
Respiratory failure
Thromboembolism
title Selective Type 2 Respiratory Failure Followed by Ocular Myasthenia Gravis Diagnosed by Ice Pack Test: A Case Report
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