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[Exacerbation of pseudoparalytic myasthenia gravis following azithromycin (Zithromax)].

Schweiz Med Wochenschr

February 1996

Medizinische Klinik, Kantonsspital Luzern, Chur.

We report the case of a 25-year-old female patient with severe aggravation of myasthenia gravis due to azithromycin which was prescribed for an influenza syndrome. One hour after the intake of 500 mg azithromycin the patient developed weakness of the legs and respiratory distress due to respiratory muscle failure. She was hospitalized in a comatose state and required intubation and mechanical ventilation for six days.

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In myasthenia gravis and amyotrophic lateral sclerosis the ENT specialist or the phoniatrician may be consulted first, because in about 30 percent of all cases the initial symptoms are dysarthria, dysphagia or dyspnea. Three typical cases of each condition are presented. The quality of life of the patients can be improved considerably by early diagnosis and treatment.

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The Authors report the results on 20 patients affected by myasthenia gravis treated by radiotherapy following the method of Bollini (1945). This treatment obtained good results in 90% of the cases. There were no deaths during therapy nor "radiation disease".

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Based on 60 of our own cases and on the medical literature the authors discuss the diagnostic, pathophysiological and therapeutic aspects of myasthenia gravis. Myasthenia is suspected in cases of motor weakness of changing intensity, diminishing by rest. The weak muscles are innervated by different peripheral nerves.

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