Open AccessAcute Respiratory Failure Induced by Magnesium Replacement in a 62-Year-Old Woman with Myasthenia Gravis
Author(s) -
Prashant Chandra Singh,
Olakunle Idowu,
Imrana Malik,
Joseph L. Nates
Publication year - 2015
Publication title -
texas heart institute journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.373
H-Index - 53
eISSN - 1526-6702
pISSN - 0730-2347
DOI - 10.14503/thij-14-4584
Subject(s) - medicine , myasthenia gravis , intensive care unit , respiratory failure , mechanical ventilation , anesthesia , weakness , intubation , neuromuscular junction , thymoma , intensive care , muscle weakness , intensive care medicine , surgery , neuroscience , biology
Magnesium is known to act at the neuromuscular junction by inhibiting the presynaptic release of acetylcholine and desensitizing the postsynaptic membrane. Because of these effects, magnesium has been postulated to potentiate neuromuscular weakness. We describe the case of a 62-year-old woman with myasthenia gravis and a metastatic thymoma who was admitted to our intensive care unit for management of a myasthenic crisis. The patient's neuromuscular weakness worsened in association with standard intravenous magnesium replacement, and the exacerbated respiratory failure necessitated intubation, mechanical ventilation, and an extended stay in the intensive care unit. The effect of magnesium replacement on myasthenia gravis patients has not been well documented, and we present this case to increase awareness and stimulate research. In addition, we discuss the relevant medical literature.