Abstract
A 45-year-old-man presented with severe vomiting, constipation, abdominal distention and bilateral ocular abductor palsy. Evaluation revealed diffuse autonomic dysfunction characterized by intestinal pseudo-obstruction, xerophthalmia, xerostomia, postural hypotension, erectile dysfunction and loss of sinus arrhythmia. Paraneoplastic work-up revealed thymoma. Most symptoms resolved after surgical removal of the thymoma. Six weeks later he developed worsening of external ophthalmoparesis with ptosis, responding to acetylcholinesterase inhibitor, confirming myasthenia gravis.
MeSH terms
-
Cholinesterase Inhibitors / therapeutic use
-
Humans
-
Intestinal Pseudo-Obstruction / diagnosis
-
Intestinal Pseudo-Obstruction / etiology*
-
Intestinal Pseudo-Obstruction / therapy
-
Male
-
Middle Aged
-
Myasthenia Gravis / complications*
-
Myasthenia Gravis / diagnosis
-
Myasthenia Gravis / drug therapy
-
Pyridostigmine Bromide / therapeutic use
-
Thymectomy
-
Thymoma / complications*
-
Thymoma / diagnosis
-
Thymoma / surgery
-
Thymus Neoplasms / complications*
-
Thymus Neoplasms / diagnosis
-
Thymus Neoplasms / surgery
-
Treatment Outcome
Substances
-
Cholinesterase Inhibitors
-
Pyridostigmine Bromide