Diagnostic dilemmas and challenges in the management of myasthenia in infants and toddlers: A case report

Myasthenia in the infancy and toddler age group is rare and often presents a challenge to treating pediatric neurologists. Our report addresses the challenges encountered when distinguishing myasthenia in infants and toddlers from similar illnesses, as well as the differentiation between congenital...

Full description

Bibliographic Details
Main Authors: Khairunnisa Mukhtiar, Mohammad Raza, Isbaah Tejani, Farhan Ali, Shahnaz Ibrahim
Format: Article
Language:English
Published: SAGE Publishing 2023-11-01
Series:SAGE Open Medical Case Reports
Online Access:https://doi.org/10.1177/2050313X231211047
_version_ 1827767453663363072
author Khairunnisa Mukhtiar
Mohammad Raza
Isbaah Tejani
Farhan Ali
Shahnaz Ibrahim
author_facet Khairunnisa Mukhtiar
Mohammad Raza
Isbaah Tejani
Farhan Ali
Shahnaz Ibrahim
author_sort Khairunnisa Mukhtiar
collection DOAJ
description Myasthenia in the infancy and toddler age group is rare and often presents a challenge to treating pediatric neurologists. Our report addresses the challenges encountered when distinguishing myasthenia in infants and toddlers from similar illnesses, as well as the differentiation between congenital myasthenia, transient myasthenia, and autoimmune myasthenia. We present four cases of myasthenia between the ages of 10 and 30 months. The diagnosis and management of these cases were challenging due to the variability in clinical presentation. Four cases of myasthenia were diagnosed, with three having autoimmune myasthenia and one having congenital myasthenic syndrome. One patient initially tested negative for acetylcholine receptor antibodies, but later tested positive after 4 months and had a rare facial diplegia finding. The patient with congenital myasthenic syndrome had a novel genetic mutation, DPAGT1 homozygous variants, and also had false positive acetylcholine receptor antibodies. These cases highlight the importance of genetic testing for all infants and toddlers suspected of having myasthenia.
first_indexed 2024-03-11T11:58:51Z
format Article
id doaj.art-8ab3149a187146a8afc4732fd11855df
institution Directory Open Access Journal
issn 2050-313X
language English
last_indexed 2024-03-11T11:58:51Z
publishDate 2023-11-01
publisher SAGE Publishing
record_format Article
series SAGE Open Medical Case Reports
spelling doaj.art-8ab3149a187146a8afc4732fd11855df2023-11-08T10:04:29ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2023-11-011110.1177/2050313X231211047Diagnostic dilemmas and challenges in the management of myasthenia in infants and toddlers: A case reportKhairunnisa Mukhtiar0Mohammad Raza1Isbaah Tejani2Farhan Ali3Shahnaz Ibrahim4Department of Pediatrics & Child Health, Section of Pediatric Neurology, Aga Khan University Hospital, Karachi, PakistanDepartment of Pediatrics & Child Health, Section of Pediatric Neurology, Aga Khan University Hospital, Karachi, PakistanAga Khan University, Karachi, PakistanDepartment of Pediatrics & Child Health, Section of Pediatric Neurology, Aga Khan University Hospital, Karachi, PakistanDepartment of Pediatrics & Child Health, Section of Pediatric Neurology, Aga Khan University Hospital, Karachi, PakistanMyasthenia in the infancy and toddler age group is rare and often presents a challenge to treating pediatric neurologists. Our report addresses the challenges encountered when distinguishing myasthenia in infants and toddlers from similar illnesses, as well as the differentiation between congenital myasthenia, transient myasthenia, and autoimmune myasthenia. We present four cases of myasthenia between the ages of 10 and 30 months. The diagnosis and management of these cases were challenging due to the variability in clinical presentation. Four cases of myasthenia were diagnosed, with three having autoimmune myasthenia and one having congenital myasthenic syndrome. One patient initially tested negative for acetylcholine receptor antibodies, but later tested positive after 4 months and had a rare facial diplegia finding. The patient with congenital myasthenic syndrome had a novel genetic mutation, DPAGT1 homozygous variants, and also had false positive acetylcholine receptor antibodies. These cases highlight the importance of genetic testing for all infants and toddlers suspected of having myasthenia.https://doi.org/10.1177/2050313X231211047
spellingShingle Khairunnisa Mukhtiar
Mohammad Raza
Isbaah Tejani
Farhan Ali
Shahnaz Ibrahim
Diagnostic dilemmas and challenges in the management of myasthenia in infants and toddlers: A case report
SAGE Open Medical Case Reports
title Diagnostic dilemmas and challenges in the management of myasthenia in infants and toddlers: A case report
title_full Diagnostic dilemmas and challenges in the management of myasthenia in infants and toddlers: A case report
title_fullStr Diagnostic dilemmas and challenges in the management of myasthenia in infants and toddlers: A case report
title_full_unstemmed Diagnostic dilemmas and challenges in the management of myasthenia in infants and toddlers: A case report
title_short Diagnostic dilemmas and challenges in the management of myasthenia in infants and toddlers: A case report
title_sort diagnostic dilemmas and challenges in the management of myasthenia in infants and toddlers a case report
url https://doi.org/10.1177/2050313X231211047
work_keys_str_mv AT khairunnisamukhtiar diagnosticdilemmasandchallengesinthemanagementofmyastheniaininfantsandtoddlersacasereport
AT mohammadraza diagnosticdilemmasandchallengesinthemanagementofmyastheniaininfantsandtoddlersacasereport
AT isbaahtejani diagnosticdilemmasandchallengesinthemanagementofmyastheniaininfantsandtoddlersacasereport
AT farhanali diagnosticdilemmasandchallengesinthemanagementofmyastheniaininfantsandtoddlersacasereport
AT shahnazibrahim diagnosticdilemmasandchallengesinthemanagementofmyastheniaininfantsandtoddlersacasereport