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

• Published in: Internal Medicine Vol. 57; no. 2; pp. 265 - 268
• Main Authors: Horiuchi, Kazuhiro, Nagai, Azusa, Wakita, Masahiro, Ito, Shotaro, Takamura, Kei, Houzen, Hideki
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2018; Japan Science and Technology Agency
• Subjects: anti-acetylcholine receptor antibody; anti-muscle-specific tyrosine kinase antibody; Antibodies; Body weight; Case Report; Coma; Crises; Dyspnea; Edema; Emergency medical services; Fatigue; Immunoglobulins; Internal medicine; Muscles; myasthenia gravis; myasthenic crisis; myxedema coma; Protein-tyrosine kinase; Respiration; myasthenia gravis; anti-muscle-specific tyrosine kinase antibody; myasthenic crisis; anti-acetylcholine receptor antibody; myxedema coma
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.9291-17

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.