Respir Case Rep. 2018; 7(1): 47-49 | DOI: 10.5505/respircase.2018.65902

A Rare Cause of Acute Respiratory Failure: Myasthenic Crisis

Mehmet Erdem Çakmak¹, Samet Er², Derya Ademoðlu¹, Hayriye Cankar Dal¹, Sema Sarý¹, Büþra Tezcan¹, Dilek Kazancý¹, Sema Turan^1
1Department of Intensive Care, Türkiye Yüksek Ýhtisas Hospital, Ankara, Turkey
²Department of Anaesthesiology And Reanimation, Ankara Numune Training and Research Hospital, Ankara, Turkey

Myasthenia gravis is a muscle disorder characterized by weakness and rapid fatigue in the skeletal muscles. Myasthenic crisis can develop for various reasons. In this case report, a patient with respiratory distress and a myasthenic crisis who required urgent hospital admission and intensive care unit is described. He had a history of diabetes mellitus, hypertension, coronary artery bypass graft surgery, and a thymectomy due to myasthenia gravis. The patient required mechanical ventilator support in the intensive care unit as a result of acute respiratory failure due to myasthenic crisis. Pyridostigmine 120 mg 3x1 and 1 mg/kg/day prednisolone were administered. Intravenous immunoglobulin was given at a dose of 2 g/kg for 5 days. The patient was removed from the mechanical ventilator on the third day of the intensive care admission. This case is presented as myasthenic crisis as a rare cause of acute respiratory failure.

Keywords: Acute respiratory failure, myastenia gravis, myasthenic crisis

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Akut Solunum Yetmezliðinin Nadir Bir Nedeni: Myastenik Kriz

Mehmet Erdem Çakmak¹, Samet Er², Derya Ademoðlu¹, Hayriye Cankar Dal¹, Sema Sarý¹, Büþra Tezcan¹, Dilek Kazancý¹, Sema Turan^1
1Türkiye Yüksek Ýhtisas Hastanesi, Yoðun Bakým Anabilim Dalý, Ankara
²Ankara Numune Eðitim ve Araþtýrma Hastanesi, Anesteziyoloji ve Reanimasyon Anabilim Dalý, Ankara

Miyastenia gravis, iskelet kaslarýnda güçsüzlük ve çabuk yorulma ile karakterize bir kas hastalýðýdýr. Miyastenik hastalarda çeþitli nedenlerle miyastenik kriz geliþebilir. Bu olgu sunumunda solunum sýkýntýsý ile acil servise baþvuran ve yoðun bakým yatýþý gerektiren miyastenik krizli bir hasta ele alýnmýþtýr. Özgeçmiþinde, diabestes mellitus, hipertansiyon, koroner arter bypass grefti operasyonu ve miyastenia gravis nedeniyle timektomi öyküsü vardý. Hasta yoðun bakýmda mekanik ventilatör desteðinde izleme alýndý. Hastada myastenik krize baðlý akut solunum yetmezliði düþünüldü. Pridostigmin 120 mg 3x1 olarak ve 1 mg/kg/gün prednizolon baþlandý. Ýntravenöz immün globülin (IVIG) 2 gr/kg dozunda 5 gün süreyle verilmesi planlandý. Yoðun bakým yatýþýnýn 3. gününde mekanik ventilatörden ayrýldý. Akut solunum yetmezliðinin nadir bir nedeni olarak miyastenik krizli bu olguyu sunmayý amaçladýk.

Anahtar Kelimeler: Akut solunum yetmezliði, miyastenia gravis, miyastenik kriz

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