Bengaluru: Medicover Hospital doctors save 35-year-old patient from life-threatening myasthenic crisis in autoimmune overlap syndrome

Bengaluru: Doctors at Medicover Hospital successfully treated a 35-year-old man who developed a life-threatening myasthenic crisis complicated by multiple autoimmune disorders, a rare and high-risk medical emergency.

The patient first developed symptoms in February 2025, presenting with drooping of the eyelid. He was diagnosed with Myasthenia Gravis (MG), a chronic autoimmune neuromuscular disorder caused by impaired nerve–muscle communication, after blood tests confirmed the presence of acetylcholine receptor antibodies. MG is considered a rare disease, with a global prevalence of approximately 14–20 cases per 100,000 population, and studies indicate a rising incidence due to improved diagnostic awareness.

Further evaluation revealed that the patient also had Graves’ disease, an autoimmune thyroid disorder. He underwent radioiodine ablation followed by thyroid hormone replacement therapy and later a thymectomy, which is often recommended in MG to improve long-term outcomes.

He was referred to Medicover Hospital in Bengaluru with rapidly worsening symptoms, including drooping of both eyelids, difficulty in swallowing, generalized muscle weakness, and breathing difficulty. Advanced testing revealed the presence of additional autoimmune antibodies (Anti-SSA and Anti-SSB), indicating a rare overlap autoimmune condition. Such overlap syndromes are uncommon and significantly increase disease severity and treatment complexity.

Despite initial medical management, the patient developed acute respiratory failure, progressing into a myasthenic crisis, a medical emergency that occurs in about 15–20 per cent of patients with Myasthenia Gravis and carries a high risk of mortality if not treated promptly. He was immediately shifted to the Intensive Care Unit, placed on ventilator support, and treated with intravenous immunoglobulin (IVIg) along with advanced critical care monitoring.

The patient showed rapid improvement, was successfully weaned off ventilator support within three days, and demonstrated steady neurological recovery. He was discharged in stable condition and, on follow-up, achieved complete neurological recovery, returning to normal daily activities.

Dr. Surabhi, Consultant Neurologist, said that while Myasthenia Gravis is known to be associated with thyroid disorders, its coexistence with other autoimmune conditions such as Sjögren’s syndrome is extremely rare. Early diagnosis, detailed evaluation, and coordinated multidisciplinary care were key to the successful outcome.

Dr. Nithya C. Achaiah, ICU Head, said prompt recognition of respiratory failure and immediate intensive care support played a crucial role in saving the patient’s life.

Doctors stated that timely intervention and seamless coordination between neurology and critical care teams were critical in managing this high-risk neurological emergency.