{1Assistant Professor, 2Professor, 3Associate Professor, 4Assistant Professor, 5PG Student}
Department of Pulmonary Medicine, Mahatma Gandhi Mission’s Medical College, Aurangabad, Maharashtra, INDIA.
Academic Editor : Dr. Aher K.R.
Abstract
We report a case history of a 43 yr old lady, who presented with acute abdominal pain and then went into respiratory failure. The patient was not a known case of myasthenia gravis. The Chest X-ray was normal, blood gas analysis showed respiratory acidosis, CT scan of abdomen showed pseudocyst of pancreas with necrosis in tail of pancreas. Myasthenia crisis can be triggered by a variety of factors, in this case by acute pancreatitis. In our case myasthenia gravis was diagnosed since we had difficulty in weaning her off from the ventilator. Myasthenia crisis with pseudocyst of pancreas and acute pancreatitis is rare. After putting her on ventilator, there was improvement in blood gas, but she could not be weaned off the ventilator even after repeated attempts because of poor respiratory muscle activity. Serum Acetylcholineesterase receptor auto antibodies were found to be high, and she was then diagnosed as having Myasthenia gravis. Myasthenia gravis should be suspected in a patient with unexplained respiratory failure.
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