A Child with Myasthenic Crisis Who was Firstly Diagnosed as Bronchial Asthma

Abstract

We report an 11-year-old girl with myasthenic crisis, who was initially diagnosed as respiratory distress due to status asthmatics.There were several points which confused us to lead the final diagnosis;glucocorticoid was effective;ptosis was not obvious;fatigability of muscles and diurnal symptom fluctuation was not noticed.In contrast, there were some findings which were not compatible with asthma exacerbation ;she had no wheezing and her respiratory distress did not apparently respond to bronchodilators.Finally bulbar palsy was found, and the diagnosis of myasthenia gravis (MG) was confirmed by a positive anticholinesterase test, specific findings of electromyography, and a positive anti-acetylcholine receptor antibody.When a patient with respiratory distress has facial weakness and dysphagia, MG should be considered.