Myasthenia gravis complicated by intestinal pseudo-obstruction: a case report and literature review.

PURPOSE: Myasthenia gravis (MG) is an autoimmune disease characterized by fluctuating weakness of skeletal muscles, usually without involvement of gastrointestinal muscle groups. However, when accompanied by intestinal pseudo-obstruction (IPO), patients may present with gastrointestinal symptoms, complicating prompt diagnosis. We report two new cases of MG complicated by IPO, detailing their clinical course and management. METHODS: A case report and review of the literature. RESULTS: We report two new cases of young male MG complicated by IPO. Both patients were admitted with symptoms indicative of intestinal obstruction and achieved clinical remission following thymectomy. We identified a total of 14 cases of MG complicated by IPO, including 12 previously reported in the literature. Of these cases, IPO was the initial clinical manifestation in 64.3% (9/14). 12 (85.7%) of them were correlated with thymoma, and only one patient did not undergo thymectomy. Ten patients showed clinical improvement, while the remaining four succumbed to the disease progression or complications. CONCLUSIONS: It is challenging to diagnose MG complicated by IPO at the initial presentation. We should be careful to avoid unnecessary colectomies in the treatment process.