Hamizah R, Norlinah M I, Tan H J, Soehardy Z, Halim A G, Rohana A G, Hamidon B B, Kong N C T, Raymond A A
Department of Medicine, Hospital UKM, Jalan Yaacob Latiff, Bandar Tun Razak 56000, Kuala Lumpur.
Med J Malaysia. 2006 Dec;61(5):633-5.
A 20-year-old girl first notice bilateral ocular muscle weakness in 2001. Two months later, she developed acute muscle paralysis and respiratory failure which required ventilation. Serum anti-acetylcholine receptor antibodies and repetitive nerve stimulation test was positive and consistent with myasthenia gravis (MG). CT scan thorax revealed thymic enlargement and she underwent a video assisted thymectomy (VATS). However, over the next three years, despite maximal doses of various immunosuppressive agents with plasmapheresis and intravenous immunoglobulin, she was admitted with recurrent myasthenic crisis without any obvious precipitant. She was then commenced on mycophenolate mofetil and together with regular plasmapheresis, cyclosporine and prednisolone, her symptoms have finally improved and brought under control.
一名20岁女孩于2001年首次发现双侧眼肌无力。两个月后，她出现急性肌肉麻痹和呼吸衰竭，需要通气治疗。血清抗乙酰胆碱受体抗体及重复神经电刺激试验呈阳性，符合重症肌无力（MG）。胸部CT扫描显示胸腺肿大，她接受了电视辅助胸腺切除术（VATS）。然而，在接下来的三年里，尽管使用了各种免疫抑制剂的最大剂量，并进行了血浆置换和静脉注射免疫球蛋白治疗，但她仍在无明显诱因的情况下因重症肌无力危象复发而入院。随后她开始使用霉酚酸酯，并结合定期血浆置换、环孢素和泼尼松龙治疗，她的症状最终得到改善并得到控制。
