Bravo Domínguez O, Foglia Fernández M, González Compte X, Jiménez Montoya R, Girons Bonells J, Dicenta Sousa M
Servicio de ORL, Ciudad Sanitaria y Universitaria de Bellvitge, Barcelona.
Acta Otorrinolaringol Esp. 2000 Aug-Sep;51(6):549-51.
Myasthenia gravis is an illness of insidious onset whose first manifestation often is dysphagia. We report the case of a 25 year-old woman who consulted for nosebleed. On her first visit she referred progressive dysphagia, but the results of endoscopic digestive examination and indirect laryngoscopy were normal. The condition evolved until the appearance of weakness of the extremities suggested myasthenia. Myasthenia gravis was diagnosed by means of electromyography and determinations of antibodies against acetylcholine receptors. We reviewed the literature on the clinical manifestations, diagnostic procedures, and treatment of this condition. This case highlights the importance of suspecting myasthenia gravis in young women with dysphagia and a family or personal history of autoimmune disease in order to reach an early diagnosis and treatment.
重症肌无力是一种起病隐匿的疾病，其首发症状往往是吞咽困难。我们报告一例25岁因鼻出血前来就诊的女性病例。首次就诊时，她自述有进行性吞咽困难，但内镜消化检查和间接喉镜检查结果均正常。病情进展，直至出现肢体无力提示重症肌无力。通过肌电图检查和抗乙酰胆碱受体抗体测定确诊为重症肌无力。我们回顾了关于该疾病临床表现、诊断方法及治疗的文献。该病例强调了对于有吞咽困难且有自身免疫性疾病家族史或个人史的年轻女性怀疑重症肌无力以实现早期诊断和治疗的重要性。
