PT  - JOURNAL ARTICLE
AU  - Kayleigh Jessop
TI  - Intravenous magnesium sulfate inducing acute respiratory failure in a patient with myasthenia gravis
AID  - 10.1136/bcr-2022-250455
DP  - 2022 Jun 01
TA  - BMJ Case Reports
PG  - e250455
VI  - 15
IP  - 6
4099  - http://casereports.bmj.com/content/15/6/e250455.short
4100  - http://casereports.bmj.com/content/15/6/e250455.full
SO  - BMJ Case Reports2022 Jun 01; 15
AB  - A woman in her 90s with a background of myasthenia gravis and atrial fibrillation presented to hospital following a fall. While in the emergency department it was noted that she was in atrial fibrillation with a fast-ventricular response and as part of her management was given intravenous magnesium. Following this she developed acute respiratory failure and required intubation and ventilation. The patient recovered quickly and was extubated in the intensive care unit the next day. On subsequent days, the patient received two further doses of intravenous magnesium before the link was identified. On both of these occasions she again developed respiratory failure which were managed with non-invasive ventilation. This case highlights the importance of all members of the team being aware of the drugs that can induce a myasthenic crisis. It also stimulates further research into the development of a guide of how to safely treat symptomatic hypomagnesaemia in patients with myasthenia gravis.