Bonanni Luca, Dalla Vestra Michele, Zancanaro Andrea, Presotto Fabio
Department of Internal Medicine, "Dell'Angelo" General Hospital, 11 Paccagnella Street, Mestre, 30171 Venice, Italy.
Case Rep Radiol. 2014;2014:963461. doi: 10.1155/2014/963461. Epub 2014 Dec 3.
We describe the case of 79-year-old man admitted to our general hospital for a 6-week history of progressive dysphagia to solids and liquids associated with weight loss. To reach a diagnosis a total body CT scan with low-osmolality iodinate contrast agent was performed. Two hours later the patient developed an acute respiratory failure requiring orotracheal intubation and mechanical ventilation. The laboratory and neurological tests allow formulating the diagnosis of myasthenia gravis. In literature, other three case reports have associated myasthenic crisis with exposure to low-osmolality contrast media. This suggests being careful in administering low-osmolality contrast media in myasthenic patients.
我们描述了一名79岁男性患者的病例，该患者因进行性吞咽固体和液体困难伴体重减轻6周而入住我院综合医院。为明确诊断，进行了低渗碘造影剂全身CT扫描。两小时后，患者出现急性呼吸衰竭，需要经口气管插管和机械通气。实验室和神经学检查有助于明确重症肌无力的诊断。在文献中，另外三篇病例报告将重症肌无力危象与低渗造影剂暴露相关联。这表明在给重症肌无力患者使用低渗造影剂时要谨慎。
