title: Intestinal pseudo-obstruction as initial presentation of thymoma.
abstract: A 45-year-old-man presented with severe vomiting, constipation, abdominal distention and bilateral ocular abductor palsy. Evaluation revealed diffuse autonomic dysfunction characterized by intestinal pseudo-obstruction, xerophthalmia, xerostomia, postural hypotension, erectile dysfunction and loss of sinus arrhythmia. Paraneoplastic work-up revealed thymoma. Most symptoms resolved after surgical removal of the thymoma. Six weeks later he developed worsening of external ophthalmoparesis with ptosis, responding to acetylcholinesterase inhibitor, confirming myasthenia gravis.
authors.affiliation: Department of Gastroenterology, Amrita Institute of Medical Sciences, Amrita Lane, Elamakkara P O, Cochin 682 026, India. musthafacpdr@gmail.com
authors.forename: C P
authors.initials: CP
authors.lastname: Musthafa
authors.forename: Ahsan
authors.initials: A
authors.lastname: Moosa
authors.forename: P A
authors.initials: PA
authors.lastname: Chandrashekharan
authors.forename: R
authors.initials: R
authors.lastname: Nandakumar
authors.forename: A V
authors.initials: AV
authors.lastname: Narayanan
authors.forename: V
authors.initials: V
authors.lastname: Balakrishnan
mesh_terms: D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011729:Pyridostigmine Bromide / Q000627:therapeutic use; D013934:Thymectomy; D013945:Thymoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D013953:Thymus Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors; D011729:Pyridostigmine Bromide