Combating Respiratory Failure due to Myasthenia Crisis in Area with Limited Resources; A Case Report: Combating Respiratory Failure due to Myasthenia Crisis

Emanuel Christoforus Lienanto; Yosefina Djati; Remidazon Riba; Nugroho Budi

doi:10.59747/smjidisurabaya.v3i2.78

Authors

Emanuel Christoforus Lienanto Faculty of Medicine, Hang Tuah University, Surabaya, East Java, Indonesia
Yosefina Djati T.C Hillers Public Hospital, Maumere, East Nusa Tenggara, Indonesia
Remidazon Riba T.C Hillers Public Hospital, Maumere, East Nusa Tenggara, Indonesia
Nugroho Budi Ubaya Hospital, Surabaya, East Java, Indonesia https://orcid.org/0000-0002-4756-4458

DOI:

https://doi.org/10.59747/smjidisurabaya.v3i2.78

Keywords:

IVIG, Myasthenia crisis, Myasthenia gravis, Plasmapheresis, Respiratory failure

Abstract

Background: Myasthenia crisis is a complication of myasthenia gravis that is characterized by respiratory muscle weakness resulting in respiratory failure. This condition often requires intubation and mechanical ventilation. Myasthenia crisis is a complication of myasthenia gravis that is characterized by respiratory muscle weakness resulting in respiratory failure. An impending crisis may be presented by dyspnea and bulbar symptoms. The occurrence of these symptoms indicates immediate attention.

Objectives: This paper reports an unusual case of myasthenia crisis in remote areas with limited management resources.

Case: A patient with a history of myasthenia gravis was admitted with a chief complaint of dyspnoea two days prior to admission. Then, the patient’s condition worsened until he was in a critical period due to loss of consciousness and respiratory failure. Intubation and mechanical ventilation were performed. The patient’s condition gradually improved, and in the fourth week after admission, mechanical ventilation was discontinued, extubated and able to breathe spontaneously. Plasmapheresis was given afterward.

Conclusion: Myasthenia crisis is a common complication of myasthenia gravis that requires immediate attention. Risk factors that trigger a crisis should be identified early so that the patient can be given immediate treatment if necessary. Either plasmapheresis or IVIG should be given as early as possible, depending on availability at the hospital.

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Combating Respiratory Failure due to Myasthenia Crisis in Area with Limited Resources; A Case Report