PMID- 38222201
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240116
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 12
DP  - 2023 Dec
TI  - Anti-Muscle-Specific Kinase (MuSK) Antibody-Positive Myasthenia Gravis Presenting 
      With Dyspnea in an Elderly Woman: A Case Report.
PG  - e50480
LID - 10.7759/cureus.50480 [doi]
LID - e50480
AB  - Myasthenia gravis (MG) is an autoimmune disease and represents one of the most 
      common disorders associated with neuromuscular transmission defects. Within MG, 
      the anti-muscle-specific kinase antibody-positive subtype (MuSK-positive MG) is 
      rare. While it shares similarities with the common form of MG by presenting with 
      ocular weakness, MuSK-positive MG typically presents with more atypical symptoms. 
      Although MuSK-positive MG can lead to type 2 respiratory failure due to 
      respiratory weakness, there have been limited reports where initial presentation 
      involves only respiratory compromise. This study details a case of MuSK-positive 
      MG presenting dyspnea. An 84-year-old female presented to the emergency 
      department due to a three-day history of progressive respiratory distress, 
      characterized by increased respiratory effort and shallow breathing, resulting in 
      a diagnosis of type 2 respiratory failure. Despite the absence of neurological 
      abnormalities, she tested positive for anti-muscle-specific kinase antibodies, 
      confirming a diagnosis of MuSK-positive MG. This case highlights the significance 
      of considering MG in the context of type 2 respiratory failure, even in the 
      absence of typical neurological symptoms, especially in elderly patients.
CI  - Copyright (c) 2023, Shiozumi et al.
FAU - Shiozumi, Tadaharu
AU  - Shiozumi T
AD  - Department of Emergency Medicine, Kyoto Prefectural University of Medicine, 
      Kyoto, JPN.
FAU - Okada, Nobunaga
AU  - Okada N
AD  - Department of Emergency Medicine, Japanese Red Cross Society Kyoto Daiichi 
      Hospital, Kyoto, JPN.
FAU - Matsuyama, Tasuku
AU  - Matsuyama T
AD  - Department of Emergency Medicine, Kyoto Prefectural University of Medicine, 
      Kyoto, JPN.
FAU - Yamahata, Yoshihiro
AU  - Yamahata Y
AD  - Department of Emergency Medicine, Kyoto Prefectural University of Medicine, 
      Kyoto, JPN.
FAU - Ohta, Bon
AU  - Ohta B
AD  - Department of Emergency Medicine, Kyoto Prefectural University of Medicine, 
      Kyoto, JPN.
LA  - eng
PT  - Case Reports
DEP - 20231213
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10786710
OTO - NOTNLM
OT  - atypical presentation
OT  - elderly onset
OT  - musk antibody
OT  - myasthenia gravis
OT  - respiratory failure
COIS- The authors have declared that no competing interests exist.
EDAT- 2024/01/15 06:42
MHDA- 2024/01/15 06:43
PMCR- 2023/12/13
CRDT- 2024/01/15 04:30
PHST- 2023/12/13 00:00 [accepted]
PHST- 2024/01/15 06:43 [medline]
PHST- 2024/01/15 06:42 [pubmed]
PHST- 2024/01/15 04:30 [entrez]
PHST- 2023/12/13 00:00 [pmc-release]
AID - 10.7759/cureus.50480 [doi]
PST - epublish
SO  - Cureus. 2023 Dec 13;15(12):e50480. doi: 10.7759/cureus.50480. eCollection 2023 
      Dec.