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American Journal of Medical Case Reports. 2020, 8(6), 148-149
DOI: 10.12691/AJMCR-8-6-3
Case Study

New Diagnosis of Myasthenia Gravis Following Magnesium Replacement

Tyler Kemnic1, , James Choi1, Samanjit Kandola1 and Khader Herzallah1

1Michigan State University, United States

Pub. Date: April 02, 2020
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Cite this paper

Tyler Kemnic, James Choi, Samanjit Kandola and Khader Herzallah. New Diagnosis of Myasthenia Gravis Following Magnesium Replacement. American Journal of Medical Case Reports. 2020; 8(6):148-149. doi: 10.12691/AJMCR-8-6-3

Abstract

A 29-year-old female G2P2 with a past medical history of hyperthyroidism and depression was admitted for 2-months of progressively worsening weakness of her bilateral upper and lower extremities. Initial investigations were unremarkable, and the patient’s weakness improve the next morning. The patient was thought to have a Somatoform Disorder and was planned for home discharge, however on the day of discharge her magnesium was 1.2 mg/dL. After repletion, she developed seizure-like activity and respiratory failure, requiring mechanical ventilation and transfer to the ICU. In ICU, patient received another dose of replacement magnesium that caused another seizure, code blue and re-intubation. Subsequent lab work revealed reactive Acetylcholine receptor antibodies and subsequent chest imaging demonstrated thymoma, confirming a diagnosis of Myasthenia Gravis in Crisis. The patient improved following plasma exchange and was discharged home with outpatient follow up.

Keywords

myasthenia gravis, magnesium, seizure

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]  https://rarediseases.info.nih.gov/diseases/7122/myasthenia-gravi Accessed 8/3/2019.
 
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[4]  Fawcett WJ, Haxby EJ, Male DA. Magnesium: physiology and pharmacology. Br J Anaesth. 1999; 83(2): 302-20.
 
[5]  Singh P, Idowu O, Malik I, Nates JL. Acute Respiratory Failure Induced by Magnesium Replacement in a 62-Year-Old Woman with Myasthenia Gravis. Tex Heart Inst J. 2015; 42(5): 495-497.