A misdiagnosed myasthenia gravis with anti-muscle-specific tyrosine kinase antibodies with possible childhood onset

Autor: Nikolić Ana V., Lavrnić Dragana V., Basta Ivana Z., Nikolić Dimitrije M., Apostolski Slobodan A.
Jazyk: English<br />Serbian
Rok vydání: 2015
Předmět:
Zdroj: Vojnosanitetski Pregled, Vol 72, Iss 7, Pp 639-641 (2015)
Druh dokumentu: article
ISSN: 0042-8450
DOI: 10.2298/VSP131111039N
Popis: Introduction. Childhood onset myasthenia gravis associated with anti-muscle-specific tyrosine kinase antibodies is very rare and atypical in presentation. Case report. As a baby, the pre-sented patient was choking and sleeping with open eyes. She had weak cry and breathing difficulties. In childhood, there were frequent falls and fluctuating swallowing difficulties. At the age of 19 she was misdiagnosed with Miller Fisher syndrome due to the presence of diplopia, ataxia and hyporeflexia with spontaneous recovery. Repetitive nerve stimulation test was normal. Four years later, after several relapses, there was significant decrement on facial muscles. Neostigmine test was negative, provoking muscle fasciculations. Serum anti-muscle-specific tyrosine kinase antibodies were positive. With cyclosporine therapy she achieved the minimal manifestations status. Conclusion. The presented case confirms that childhood onset myasthenia gravis associated with anti-muscle-specific tyrosine kinase antibodies is often with atypical presentation and spontaneous remissions, so it could be easily misdiagnosed.
Databáze: Directory of Open Access Journals