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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Main Authors: Yujuan Han, Dawei Zang, Xiaoping Kang
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Clinical Case Reports
Subjects:
Online Access:https://doi.org/10.1002/ccr3.70434
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author Yujuan Han
Dawei Zang
Xiaoping Kang
author_facet Yujuan Han
Dawei Zang
Xiaoping Kang
author_sort Yujuan Han
collection DOAJ
description 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.
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spelling doaj-art-eb2f9729a8ec4460923ee5dc95716b5b2025-08-20T02:24:35ZengWileyClinical Case Reports2050-09042025-04-01134n/an/a10.1002/ccr3.70434Very Late‐Onset Myasthenia Gravis Presenting With Dysphagia and Gradual Decrease in Laryngeal Elevation During Repeated Swallowing: A Case ReportYujuan Han0Dawei Zang1Xiaoping Kang2Tiantan Xiaotangshan Rehabilitation Center Beijing Xiaotangshan Hospital Beijing ChinaDepartment of Rehabilitation Medicine Beijing Tiantan Hospital, Capital Medical University Beijing ChinaTiantan Xiaotangshan Rehabilitation Center Beijing Xiaotangshan Hospital Beijing ChinaABSTRACT 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.https://doi.org/10.1002/ccr3.70434dysphagiaelderlymyasthenic crisisupper gastrointestinal radiographyvery late‐onset myasthenia gravis
spellingShingle Yujuan Han
Dawei Zang
Xiaoping Kang
Very Late‐Onset Myasthenia Gravis Presenting With Dysphagia and Gradual Decrease in Laryngeal Elevation During Repeated Swallowing: A Case Report
Clinical Case Reports
dysphagia
elderly
myasthenic crisis
upper gastrointestinal radiography
very late‐onset myasthenia gravis
title Very Late‐Onset Myasthenia Gravis Presenting With Dysphagia and Gradual Decrease in Laryngeal Elevation During Repeated Swallowing: A Case Report
title_full Very Late‐Onset Myasthenia Gravis Presenting With Dysphagia and Gradual Decrease in Laryngeal Elevation During Repeated Swallowing: A Case Report
title_fullStr Very Late‐Onset Myasthenia Gravis Presenting With Dysphagia and Gradual Decrease in Laryngeal Elevation During Repeated Swallowing: A Case Report
title_full_unstemmed Very Late‐Onset Myasthenia Gravis Presenting With Dysphagia and Gradual Decrease in Laryngeal Elevation During Repeated Swallowing: A Case Report
title_short Very Late‐Onset Myasthenia Gravis Presenting With Dysphagia and Gradual Decrease in Laryngeal Elevation During Repeated Swallowing: A Case Report
title_sort very late onset myasthenia gravis presenting with dysphagia and gradual decrease in laryngeal elevation during repeated swallowing a case report
topic dysphagia
elderly
myasthenic crisis
upper gastrointestinal radiography
very late‐onset myasthenia gravis
url https://doi.org/10.1002/ccr3.70434
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AT daweizang verylateonsetmyastheniagravispresentingwithdysphagiaandgradualdecreaseinlaryngealelevationduringrepeatedswallowingacasereport
AT xiaopingkang verylateonsetmyastheniagravispresentingwithdysphagiaandgradualdecreaseinlaryngealelevationduringrepeatedswallowingacasereport