CASE ANALYSIS

is a relatively rare autoimmune disorder in which

antibodies form against acetylcholine nicotinic
postsynaptic receptors at the neuromuscular junction of
skeletal muscles
is sometimes identified as having an ocular and
generalized form, although one is not exclusive of the other
and the ocular form is considered an initial, milder form of
illness that progresses to the more severe generalized form
in most but not all patients.
Si ho, a 21 year-old gymnastic student,
presents with complaints of muscle
weakness in her face that comes and goes,
but has been getting worse over the past
two months. Most notably, she complains
that her jaw gets tired as she chews and
that swallowing has become difficult. She
also notes diplopia (double vision) which
seems to come on late in the evening,
particularly after reading for a few
minutes. At work, it has become
increasingly difficult to spot her
gymnasts during acrobatic moves because
of upper arm weakness.
OTHER SYMPTOMS:
Shortness of breath
Neck and upper spine
pain
Chest pain and difficulty
breathing
Could not move her head
up for more than few
minutes at a time
Symptoms worsen with
fatigue
 HEMATOLOGY
COMPLETE BLOOD COUNT REFERENCE RANGE RESULTS REMARK
S
RED BLOOD CELLS 4.2-5.4 million cells/ul 5.0 million NORMAL
cells/ul
WHITE BLOOD CELLS 4,500-10,000/ul 8,800 cells /ul NORMAL
PLATELETS 150,000-450,000/ul 300, 000/ul NORMAL
HEMOGLOBIN 12-15 g/dl 14g/dl NORMAL
HEMATOCRIT 36-48% 45% NORMAL
 TEST RESULT
ANTI-ACETYLCHOLINE RECEPTOR POSITIVE
ANTIBODIES
BIOPSY RESULT (thymus)

Thymus is enlarged. Lymphoid hyperplasia of the thymus ,increased number of

lymphoid follicles. The tumor ranged in size from 7x2.5x3 cm.
 After having a positive result for ACETYCHOLINE RECEPTOR
ANTIBODY TEST, Si Ho was diagnosed with Myasthenia
Gravis. CT Scan of her chest revealed a mediastinal mass. Thus,
thymectomy was performed. Histopathology result revealed a
benign tumor.