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.