A Comprehensive Approach to Myasthenia Gravis With Thymoma: A Case Report Highlighting Management of Myasthenic Crisis and Post-Crisis Care

Abstract

Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disorder that leads to muscle weakness and rapid fatigue, often exacerbated by thymoma, a tumor of the thymus gland. This case report presents the clinical management of a 40-year-old female with MG complicated by thymoma, who presented with a severe myasthenic crisis. The patient required intensive care, including respiratory support, plasmapheresis, and immunosuppressive therapy. Initial evaluations confirmed the diagnosis of MG through the detection of high levels of anti-acetylcholine receptor antibodies, and a CT scan revealed a thymic mass, indicative of thymoma. The management strategy included acetylcholinesterase inhibitors, immunosuppressive agents, and supportive therapies to stabilize the patient. The patient responded positively to plasmapheresis, which significantly improved her condition. Follow-up CT imaging confirmed the presence of thymoma, reinforcing the need for further investigation into surgical interventions such as thymectomy. The report also emphasizes the critical role of a multidisciplinary approach in managing MG with thymoma, underscoring the importance of early diagnosis and timely intervention to prevent recurrent crises. Additionally, it discusses the evolving role of thymectomy in MG patients with thymoma and the potential of newer treatments, such as complement inhibitors, for refractory cases. This case highlights the complexities of managing MG complicated by thymoma and stresses the importance of ongoing research into therapeutic strategies. Early diagnosis, effective management, and continuous monitoring remain essential to optimizing outcomes for patients with these complex conditions.