伴胃肠功能障碍表现重症肌无力1例  

Myasthenia gravis with gastrointestinal dysfunction:a case report

作　　者：陆慧[1] 黄安琪 王茜 刘恒 李海峰 LU Hui;HUANG Anqi;WANG Qian;LIU Heng;LI Haifeng(Xuanwu Hospital Capital Medical University,Beijing 100053,China)

机构地区：[1]北京市首都医科大学宣武医院神经内科,北京100053 [2]河北省唐山市开滦总医院神经内科一病区 [3]河北省承德市承德医学院附属医院神经内科

出　　处：《中国神经精神疾病杂志》2022年第11期691-694,共4页Chinese Journal of Nervous and Mental Diseases

基　　金：国家自然科学基金青年科学基金项目(编号:82201489)。

摘　　要：本文报告1例伴有胃轻瘫和不全肠梗阻的重症肌无力(myasthenia gravis,MG)患者,主要表现为眼睑下垂、复视、腹胀及便秘,胸部CT提示胸腺瘤,疲劳试验阳性,结合患者血清抗体检测结果考虑重症肌无力诊断明确,患者接受手术切除胸腺瘤、甲强龙冲击治疗后继续口服溴吡斯的明、糖皮质激素、他克莫司,上述症状完全缓解。MG是一种自身免疫性疾病,常表现为骨骼肌受累,少见胃肠道功能障碍,但神经内科医师应当意识到MG与包括胃肠功能障碍在内的自主神经症状间的关系。We reported a case of Myasthenia gravis(MG)with gastroparesis and incomplete intestinal obstruction,whose clinical manifestation were diplopia,ptosis,flatulence,and constipation.Chest CT examination revealed thymoma.she was then diagnosed as having MG according to muscle fatigue test and serum antibody tests.The symptoms were completely relieved after the treatment with thymectomy,intravenous steroid,tacrolimus,and pyridostigmine bromide.Gastrointestinal dysfunction is rare in MG,an autoimmune disease,which usually presents as weakness of skeletal muscles.However,neurologists should realize the relationship between MG and autonomic nervous symptoms including gastrointestinal symptoms.

关 键 词：重症肌无力 胸腺瘤 胃轻瘫 肠梗阻 抗乙酰胆碱受体抗体 自身免疫 自主神经症状 

分 类 号：R746.1[医药卫生—神经病学与精神病学]