Very Late‐Onset Myasthenia Gravis Presenting With Dysphagia and Gradual Decrease in Laryngeal Elevation During Repeated Swallowing: A Case Report

ABSTRACT Very late‐onset myasthenia gravis (VLOMG) is rare myasthenia gravis (MG) that begins after the age of 65 years. Here, we describe a 72‐year‐old patient who presented with dysphagia. Upper gastrointestinal radiography revealed delayed initiation of swallowing in the pharynx and inadequate op...

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Bibliographic Details
Main Authors: Yujuan Han, Dawei Zang, Xiaoping Kang
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Clinical Case Reports
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Online Access:https://doi.org/10.1002/ccr3.70434
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Summary:ABSTRACT Very late‐onset myasthenia gravis (VLOMG) is rare myasthenia gravis (MG) that begins after the age of 65 years. Here, we describe a 72‐year‐old patient who presented with dysphagia. Upper gastrointestinal radiography revealed delayed initiation of swallowing in the pharynx and inadequate opening of the upper esophageal sphincter. Notably, there was a gradual decrease in laryngeal elevation, which strongly suggested MG. Additionally, the frequency of swallowing was reduced, and anti‐acetylcholine receptor (anti‐AChR) antibodies were positive. Due to type I respiratory failure, the patient required a tracheotomy and ventilator support. By the time of hospital discharge, the patient was able to walk out independently with a stomach tube and tracheotomy cannula. In conclusion, VLOMG should be considered in patients over 65 years old who present with sudden, isolated dysphagia or dysarthria, particularly when there is a gradual decrease in laryngeal elevation during swallowing as observed on upper gastrointestinal radiography.
ISSN:2050-0904