A misdiagnosed myasthenia gravis with anti-muscle-specific tyrosine kinase antibodies with possible childhood onset

Introduction. Childhood onset myasthenia gravis associated with anti-muscle-specific tyrosine kinase antibodies is very rare and atypical in presentation. Case report. As a baby, the pre-sented patient was choking and sleeping with open eyes. She had weak cry and breathing difficulties. In...

Full description

Saved in:
Bibliographic Details
Main Authors: Nikolić Ana V., Lavrnić Dragana V., Basta Ivana Z., Nikolić Dimitrije M., Apostolski Slobodan A.
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2015-01-01
Series:Vojnosanitetski Pregled
Subjects:
Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500039N.pdf
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849739667100925952
author Nikolić Ana V.
Lavrnić Dragana V.
Basta Ivana Z.
Nikolić Dimitrije M.
Apostolski Slobodan A.
author_facet Nikolić Ana V.
Lavrnić Dragana V.
Basta Ivana Z.
Nikolić Dimitrije M.
Apostolski Slobodan A.
author_sort Nikolić Ana V.
collection DOAJ
description Introduction. Childhood onset myasthenia gravis associated with anti-muscle-specific tyrosine kinase antibodies is very rare and atypical in presentation. Case report. As a baby, the pre-sented patient was choking and sleeping with open eyes. She had weak cry and breathing difficulties. In childhood, there were frequent falls and fluctuating swallowing difficulties. At the age of 19 she was misdiagnosed with Miller Fisher syndrome due to the presence of diplopia, ataxia and hyporeflexia with spontaneous recovery. Repetitive nerve stimulation test was normal. Four years later, after several relapses, there was significant decrement on facial muscles. Neostigmine test was negative, provoking muscle fasciculations. Serum anti-muscle-specific tyrosine kinase antibodies were positive. With cyclosporine therapy she achieved the minimal manifestations status. Conclusion. The presented case confirms that childhood onset myasthenia gravis associated with anti-muscle-specific tyrosine kinase antibodies is often with atypical presentation and spontaneous remissions, so it could be easily misdiagnosed.
format Article
id doaj-art-ffbae44ff2f04efabe4a0580ebf04b5f
institution DOAJ
issn 0042-8450
language English
publishDate 2015-01-01
publisher Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
record_format Article
series Vojnosanitetski Pregled
spelling doaj-art-ffbae44ff2f04efabe4a0580ebf04b5f2025-08-20T03:06:13ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502015-01-0172763964110.2298/VSP131111039N0042-84501500039NA misdiagnosed myasthenia gravis with anti-muscle-specific tyrosine kinase antibodies with possible childhood onsetNikolić Ana V.0Lavrnić Dragana V.1Basta Ivana Z.2Nikolić Dimitrije M.3Apostolski Slobodan A.4Clinical Center of Serbia, Neurology Clinic, Belgrade + Faculty of Medicine, BelgradeClinical Center of Serbia, Neurology Clinic, Belgrade + Faculty of Medicine, BelgradeClinical Center of Serbia, Neurology Clinic, Belgrade + Faculty of Medicine, BelgradeFaculty of Medicine, Belgrade + University Children’s Hospital, Neurology Department, BelgradPrivate Neurological Practice “Apostolski”, Belgrade, SerbiaIntroduction. Childhood onset myasthenia gravis associated with anti-muscle-specific tyrosine kinase antibodies is very rare and atypical in presentation. Case report. As a baby, the pre-sented patient was choking and sleeping with open eyes. She had weak cry and breathing difficulties. In childhood, there were frequent falls and fluctuating swallowing difficulties. At the age of 19 she was misdiagnosed with Miller Fisher syndrome due to the presence of diplopia, ataxia and hyporeflexia with spontaneous recovery. Repetitive nerve stimulation test was normal. Four years later, after several relapses, there was significant decrement on facial muscles. Neostigmine test was negative, provoking muscle fasciculations. Serum anti-muscle-specific tyrosine kinase antibodies were positive. With cyclosporine therapy she achieved the minimal manifestations status. Conclusion. The presented case confirms that childhood onset myasthenia gravis associated with anti-muscle-specific tyrosine kinase antibodies is often with atypical presentation and spontaneous remissions, so it could be easily misdiagnosed.http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500039N.pdfmyasthenia gravischilddiagnosis, differentialantibodiesprotein-tyrosine kinases
spellingShingle Nikolić Ana V.
Lavrnić Dragana V.
Basta Ivana Z.
Nikolić Dimitrije M.
Apostolski Slobodan A.
A misdiagnosed myasthenia gravis with anti-muscle-specific tyrosine kinase antibodies with possible childhood onset
Vojnosanitetski Pregled
myasthenia gravis
child
diagnosis, differential
antibodies
protein-tyrosine kinases
title A misdiagnosed myasthenia gravis with anti-muscle-specific tyrosine kinase antibodies with possible childhood onset
title_full A misdiagnosed myasthenia gravis with anti-muscle-specific tyrosine kinase antibodies with possible childhood onset
title_fullStr A misdiagnosed myasthenia gravis with anti-muscle-specific tyrosine kinase antibodies with possible childhood onset
title_full_unstemmed A misdiagnosed myasthenia gravis with anti-muscle-specific tyrosine kinase antibodies with possible childhood onset
title_short A misdiagnosed myasthenia gravis with anti-muscle-specific tyrosine kinase antibodies with possible childhood onset
title_sort misdiagnosed myasthenia gravis with anti muscle specific tyrosine kinase antibodies with possible childhood onset
topic myasthenia gravis
child
diagnosis, differential
antibodies
protein-tyrosine kinases
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500039N.pdf
work_keys_str_mv AT nikolicanav amisdiagnosedmyastheniagraviswithantimusclespecifictyrosinekinaseantibodieswithpossiblechildhoodonset
AT lavrnicdraganav amisdiagnosedmyastheniagraviswithantimusclespecifictyrosinekinaseantibodieswithpossiblechildhoodonset
AT bastaivanaz amisdiagnosedmyastheniagraviswithantimusclespecifictyrosinekinaseantibodieswithpossiblechildhoodonset
AT nikolicdimitrijem amisdiagnosedmyastheniagraviswithantimusclespecifictyrosinekinaseantibodieswithpossiblechildhoodonset
AT apostolskislobodana amisdiagnosedmyastheniagraviswithantimusclespecifictyrosinekinaseantibodieswithpossiblechildhoodonset
AT nikolicanav misdiagnosedmyastheniagraviswithantimusclespecifictyrosinekinaseantibodieswithpossiblechildhoodonset
AT lavrnicdraganav misdiagnosedmyastheniagraviswithantimusclespecifictyrosinekinaseantibodieswithpossiblechildhoodonset
AT bastaivanaz misdiagnosedmyastheniagraviswithantimusclespecifictyrosinekinaseantibodieswithpossiblechildhoodonset
AT nikolicdimitrijem misdiagnosedmyastheniagraviswithantimusclespecifictyrosinekinaseantibodieswithpossiblechildhoodonset
AT apostolskislobodana misdiagnosedmyastheniagraviswithantimusclespecifictyrosinekinaseantibodieswithpossiblechildhoodonset