Article Text

Download PDFPDF
Case report
Persistent type 2 respiratory failure on background of advanced thymoma with lung metastases
  1. Abrar Munir,
  2. Mohsin Ijaz Khan and
  3. Jason Kah Chun Cheong
  1. Acute Internal Medicine, North Manchester General Hospital, Manchester, UK
  1. Correspondence to Dr Abrar Munir; drabrar786{at}


We report a patient in her 60s with history of end-stage thymoma with bilateral lung metastases on palliative chemotherapy presented to the hospital with sudden shortness of breath initially treated for probable pulmonary embolism (PE) pending CT of the pulmonary arteries which was subsequently negative for PE. During this admission, she developed transient right-sided facial droop and slurred speech which resolved spontaneously; however, the patient became unresponsive and desaturated with severe decompensated type 2 respiratory failure. Patient was supported with non-invasive ventilation (biphasic positive airway pressure) for few days. Myasthenia gravis was suspected due to clinical features and confirmed by the high titre of acetylcholine receptor antibody titre.

  • respiratory system
  • resuscitation
  • ethics
  • neuromuscular disease
  • endocrine cancer

Statistics from


  • Contributors AM and MIK worked for the planning and conduct of the case report. MIK and AM worked for the reporting and JKCC for the conception of the design of case report. MK and JKCC worked for the acquisition of the data and AM has done the critical analysis of the data interpretation and reporting.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.