TUBERCULOSIS UNMASKS MYASTHENIA: A UNIQUE EXPERIENCE
Abstract
Myasthenia gravis is an autoimmune disease of the neuromuscular junction where in acetylcholine receptor antibodies binds to and inhibits the action of acetylcholine, thereby presenting as weakness and fatigue on exertion. Myasthenic crisis is a life threatening condition which often mandates emergent life support measures. Tuberculosis is one of the most common causes of precipitation of myasthenic crisis in diagnosed cases of myasthenia. But here we report
a case of 25 year old female, diagnosed as sputum positive pulmonary tuberculosis, not a known case of myasthenia who presented to us with generalised weakness and severe type 2 respiratory failure subsequently diagnosed as myasthenic crisis. This case has been a singular experience and posed a challenge to us physicians with regards to successful management as because tuberculosis impeded the use of immunosuppressant to combat the highly fatal disease .
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