Myasthenia Gravis: A Case Study Focusing on Comprehensive Nursing Management

Abstract

Myasthenia Gravis (MG) is a rare, chronic autoimmune neuromuscular disorder that causes weakness in the skeletal muscles. Skeletal muscles are responsible to control voluntary actions like speaking, swallowing, breathing, and the movement of limbs.MG is caused by antibody- and cell-mediated destruction of acetylcholine receptors, leading to the blockade of neuromuscular transmission. This disruption can result in episodic skeletal muscle weakness and easy fatigability. The antibodies either block, alter, or destroy the acetylcholine receptors at the neuromuscular junction, thereby preventing proper muscle contraction. The classical presentation of patient with difficulty in breathing, increased cough and secretion. Usually, the associated symptoms are poor voluntary muscle movements involves in speaking, swallowing, breathing, and moving limbs. A 70-year-old male presented with complaint of difficulty in breathing, swallowing and slurred speech, right eye ptosis for two days and also had productive cough for 10 days. A significant past history revealed of diabetes, hypertension, and chronic kidney disease. Physical examination revealed right eye ptosis, neck weakness and difficulty in holding his neck. There was no significant family history of autoimmune diseases and without any preceding trauma or significant stressor. Radiological investigations were found to be non-significant except few laboratory investigations such as Total leucocyte count (TC), C-Reactive Protein (CRP) and Procalcitonin (PCT). The patient was treated with cholinergic agonists, corticosteroids, monoclonal antibody, Intravenous Immunoglobulin (IVIg) therapy and antimicrobial therapy which eventually helped to improve significantly. The patient got discharged in stable condition. He returned to his previous baseline lifestyle without any complications.