Perioperative Considerations of a Myasthenia Gravis Patient With Epidural Metastasis and Prior Pneumonectomy: A Case Report

Authors

Farah Aboufakhr, Corewell Health East Resident
Julie Kado, Corewell Health East
Christina Thomas, Oakland University William Beaumont School of Medicine Medical Student

Document Type

Conference Proceeding

Publication Date

10-11-2025

Abstract

The patient is a 26-year-old female with a history of myasthenia gravis crisis, malignant thymoma with metastasis, and left pneumonectomy, presenting for thoracic spine resection of epidural metastasis. She takes 480 mg of pyridostigmine daily and has had recurrent crises, including an ICU stay requiring intubation. Missing a dose of her pyridostigmine triggers bulbar symptoms and dysphagia. She also receives bimonthly Ravulizumab infusions. Due to her disease severity and medical history, pyridostigmine was continued intravenously intraoperatively. This discussion will address the pathophysiology of myasthenia gravis, drug interactions with pyridostigmine, and predictive factors of postoperative respiratory failure.

Comments

American Society of Anesthesiologist, The Anesthesiology Meeting, October 10-14, 2025, San Antonio, TX

Recommended Citation

Aboufakhr F, Kado J, Thomas C. Perioperative considerations of a myasthenia gravis patient with epidural metastasis and prior pneumonectomy: a case report. Presented at: American Society of Anesthesiologists, The Anesthesiology Meeting; 2025 Oct 11; San Antonio, TX. Available from:https://www.abstractsonline.com/pp8/#!/21028/presentation/9677