title: Severe asthma associated with myasthenia gravis and upper airway obstruction.
abstract: An unusual association of asthma and myasthenia gravis (MG) complicated by tracheal stenosis is reported. The patient was a 35-year-old black woman with a history of severe asthma and rhinitis over 30 years. A respiratory tract infection triggered a life-threatening asthma attack whose treatment required orotracheal intubation and mechanical ventilatory support. A few weeks later, tracheal stenosis was diagnosed. Clinical manifestations of MG presented 3 years after her near-fatal asthma attack. Spirometry showed severe obstruction with no response after inhalation of 400 microg of albuterol. Baseline lung function parameters were forced vital capacity, 3.29 L (105% predicted); forced expiratory volume in 1 second (FEV1), 1.10 L (41% predicted); maximal midexpiratory flow rate, 0.81 L/min (26% predicted). FEV1 after administration of albuterol was 0.87 L (32% predicted). The patient's flow-volume loops showed flattened inspiratory and expiratory limbs, consistent with fixed extrathoracic airway obstruction. Chest computed tomography scans showed severe concentric reduction of the lumen of the upper thoracic trachea.
authors: Pharmacology Department, Bahia School of Medicine and Public Health, Universidade Federal da Bahia, Salvador-Bahia, Brazil. adelmir@terra.om.br
authors: A
authors: A
authors: Souza-Machado
authors: E
authors: E
authors: Ponte
authors: A A
authors: AA
authors: Cruz
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000209:etiology*; D001249:Asthma / Q000150:complications*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D009157:Myasthenia Gravis / Q000150:complications*; D011859:Radiography; D014132:Trachea / Q000000981:diagnostic imaging / Q000473:pathology; D014135:Tracheal Stenosis / Q000209:etiology* / Q000473:pathology