Objective To investigate the clinical characteristics,causes of misdiagnosis and preventive measures of myasthenia gravis(MG).Methods We performed a retrospective analysis of the clinical data of 48 patients with MG misdi-agnosed as other diseases from January 2022 to January 2023.Results In this group,26 patients presented with ptosis,di-plopia and limited eye movement,and were misdiagnosed with oculomotor nerve palsy,and 12 patients were misdiagnosed as cerebrovascular disease due to mild dysphagia,slurred speech and coughing after drinking water.Three patients were misdiag-nosed as Lambert-Eaton syndrome due to weakness of limbs,and 2 patients presented with lumbar weakness as the initial symp-tom,and were misdiagnosed with lumbar muscle strain and lumbar disc herniation respectively.Three patients presented with simple dysphagia and were misdiagnosed as pharyngitis.One patient was misdiagnosed as coronary heart disease due to chest tightness and shortness of breath,and 1 patient was misdiagnosed as Guillain-Barre syndrome due to weakness of both lower limbs and a history of upper respiratory infection.After admission,MG was confirmed by detailed medical history,neostigmine test,detection of acetylcholine receptor antibodies,anti-muscle-specific tyrosine kinase antibodies,chest CT and electromyogra-phy.The misdiagnosis lasted 3-35 d.After diagnosis,the corresponding treatment was given,and the symptoms of all patients were significantly improved.At 6-month follow-up,there was no recurrence,and the prognosis was good.Conclusion MG is a rare autoimmune disease with diverse and atypical clinical manifestations,which is more likely to be misdiagnosed.Clinical attention should be paid to the characteristics of MG in the course of diagnosis and treatment,comprehensive analysis of the disease,and targeted examination,which can reduce or avoid misdiagnosis and mistreatment.
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