Intestinal pseudo-obstruction in a myasthenia gravis patient after thymectomy: A case report and literature review

Intestinal pseudo-obstruction in patients with myasthenia gravis is a rare and poorly understood phenomenon. We report a case coexisting with intestinal pseudo-obstruction and myasthenia gravis. The patient was diagnosed to have myasthenia gravis and underwent thymectomy seven years ago. He was tested positive for anti-acetylcholine receptor antibody and was free of thymoma recurrence during the current illness. Despite being given gastrointestinal decompression and parenteral nutrition, the patient’s gastrointestinal symptoms did not improve. Symptoms were rectified effectively by immunomodulatory therapy. This case adds intestinal pseudo-obstruction to the phenotypic profile of post-thymectomy myasthenia gravis. High titer of AChR antibody might play a role in the pathogenesis of myasthenia gravis with intestinal pseudo-obstruction.