What Is The Most Common Cause Of Death From Myasthenia Gravis?

Myasthenia gravis is generally a manageable condition and the prognosis for this condition is highly favorable. However, due to emotional stress, infection and not taking the medications as prescribed may lead to complications.

The most common cause of death of the patients suffering from myasthenia gravis is respiratory failure. Myasthenia gravis may progress into a life-threatening condition known as myasthenia gravis crisis. In myasthenia gravis crisis, the muscles of the respiratory system are severely affected. Further, the throat muscles become weak leading to narrowing the air passage. Secretion of the throat further complexes the situation. During the myasthenia gravis crisis, the muscles of the chest and diaphragm become weak leading to disruption of the respiratory process. The condition requires immediate medical intervention and the patient is put on the ventilator. In some cases, intubation is also required. ⁽¹⁾

Myasthenia gravis is an autoimmune disorder. It is generally manageable condition and the symptoms can be treated with the help of medications. In some cases, surgery is required; however, most of the cases are treated with oral or parenteral therapy. The complications of myasthenia gravis can be divided into disease-related complications and treatment-related complications. As the condition is chronic and aggressive treatment strategy is required in some cases, certain complications occur due to treatment.⁽²⁾

Following are the various complications of myasthenia gravis:

1. Disease Related Complications– The symptoms of myasthenia gravis are normally managed with the administration of various medications. The disease is kept in the remission stage. However, in certain cases, the disease has complications, some of which are normal, but some are life-threatening. ⁽³⁾

   1. Myasthenic Crisis– This is one of the most common complications of myasthenia gravis. The muscles of the whole respiratory system become weak leasing to respiratory distress in the patient. The immune system of body damage the acetylcholine receptors of the throat muscles leading to muscle collapse and increased secretion add up to the complexity. Also, the chest muscles and the diaphragm fail to function effectively leading to shallow breathing. Non-adherence to the prescription, emotional stress and respiratory infection are the common causes of myasthenia gravis crisis. In severe cases, intubation and mechanical ventilation are used until the strength of the muscles return to the normal level.
   2. Thymus Tumor– Almost 15% of the patients suffering from myasthenia gravis also have a thymoma, a tumor of the thymus glands. The tumor is generally non-cancerous and can be treated with surgery. It has also been found that most of the patient suffering from thymus tumor also have or are at increased risk of developing myasthenia gravis.
   3. Rheumatoid Arthritis– Rheumatoid arthritis is also an autoimmune disorder and is the complication of myasthenia gravis. Research indicates that both rheumatoid arthritis and juvenile rheumatoid arthritis may be the complications of myasthenia gravis. In some patients, rheumatoid arthritis causes severe physical debilitation.
   4. Thyroid Disorders– Thyroid gland, present in the neck, secretes thyroxine hormone that helps in metabolism. The patient with myasthenia gravis develops a thyroid disorder. The thyroid gland may be underactive i.e. secreted less of the thyroxine hormone or maybe overactive i.e. secreting a high quantity of thyroxine.
   5. Systemic Lupus Erythematosus– Although rarely found, Systemic Lupus Erythematosus is also the complication of myasthenia gravis. The patient suffering from SLE experiences pain, inflammation and swelling of the joints. SLE also affects various vital organs such as the kidney, lungs, and heart.

2. Treatment-Related Complications– The treatment of myasthenia gravis is chronic and is done through the potent medications. Chronic use of these medications leads to serious complications. Long term steroid therapy leads to bone disorders, eye disorders, hypertension, and infection. The cholinergic crisis is another complication due to excessive use of anticholinesterase drugs.

The most common cause of death due to myasthenia gravis is myasthenia gravis crisis in which the muscles of the respiratory system become weak leading to respiratory failure.

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Also Read:

• Myasthenia Gravis: Causes, Signs, Symptoms, Investigations, Treatment- Medications, Surgery
• What Are The Primary Features Of Myasthenia Gravis?
• How Do You Get Myasthenia Gravis?
• Factors That Can Make Myasthenia Gravis A Life-Threatening Disorder