Elderly patient diagnosed with myasthenia gravis with recurrent failed weaning and prolonged apnea

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dc.contributor.authorTorun, Cundullah
dc.contributor.authorAyazoğlu, Tülin Akarsu
dc.date.accessioned2026-01-24T12:01:04Z
dc.date.available2026-01-24T12:01:04Z
dc.date.issued2023
dc.departmentAlanya Alaaddin Keykubat Üniversitesi
dc.description.abstractMyasthenia gravis (MG) is a chronic autoimmune neuromuscular disorder caused by the development of antibodies to nicotinic acetylcholine receptors. The disease characterized by variable muscle weakness worsening with exercise. Although most patients have neurological signs and symptoms, respiratory symptoms occur in the late stages of the disease. However, rarely, respiratory failure may be the first symptom in some undiagnosed patients. We report the case of an elderly patient who was admitted with respiratory failure and intubated and transferred to the internal medicine intensive care unit. Two days after intubation, when she was awake and met the extubation criteria, endotracheal tube was successfully removed. At this time, her vital signs were normal. However, next day, her arterial blood gas CO2 rose and he became drowsy, requiring re-intubation. This situation repeated on the fifth and 16th days of her hospitalization and prolonged apnea was observed after intubation with rocuronium. All other causes of failed extubation, such as sepsis and pneumonia, were ruled out. During follow-up, ptosis was detected in the right eye and acetylcholine receptor antibody was positive. On the 30th day of the follow-up, methylprednisolone 1mg/kg and pyridostigmine 240 mg/day was initiated. The patient, whose spontaneous respiration was sufficient, was extubated and taken to the neurology clinic for further examination and treatment.
dc.identifier.endpage480
dc.identifier.issn1016-9113
dc.identifier.issn2147-6500
dc.identifier.issue3
dc.identifier.startpage477
dc.identifier.trdizinid1196616
dc.identifier.urihttps://search.trdizin.gov.tr/tr/yayin/detay/1196616
dc.identifier.urihttps://hdl.handle.net/20.500.12868/3968
dc.identifier.volume62
dc.indekslendigikaynakTR-Dizin
dc.language.isoen
dc.relation.ispartofEge Tıp Dergisi
dc.relation.publicationcategoryMakale - Ulusal Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_TR-Dizin_20260121
dc.subjectMyasthenia gravis
dc.subjectprolonged apnea
dc.subjectrocuronium bromide
dc.titleElderly patient diagnosed with myasthenia gravis with recurrent failed weaning and prolonged apnea
dc.typeArticle

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