Acute Fulminating Myasthenia Gravis in a Shih-tzu Dog

시츄 견에서 발생한 급성 전격 중증 근육무력증

  • Kang, Byeong-Teck (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University) ;
  • Yoo, Jong-Hyun (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University) ;
  • Park, Hyo-Jin (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University) ;
  • Jung, Dong-In (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University) ;
  • Park, Chul (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University) ;
  • Gu, Su-Hyun (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University) ;
  • Jeon, Hyo-Won (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University) ;
  • Kim, Ju-Won (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University) ;
  • Kim, Ha-Jung (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University) ;
  • Lim, Chae-Young (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University) ;
  • Cho, Sue-Kyung (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University) ;
  • Lee, So-Young (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University) ;
  • Heo, Ra-Young (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University)
  • 강병택 (건국대학교 수의과대학 내과학교실) ;
  • 유종현 (서울대학교 수의과대학 내과학교실) ;
  • 박효진 (건국대학교 수의과대학 내과학교실) ;
  • 정동인 (건국대학교 수의과대학 내과학교실) ;
  • 박철 (건국대학교 수의과대학 내과학교실) ;
  • 곽수현 (건국대학교 수의과대학 내과학교실) ;
  • 전효원 (건국대학교 수의과대학 내과학교실) ;
  • 김주원 (건국대학교 수의과대학 내과학교실) ;
  • 김하정 (건국대학교 수의과대학 내과학교실) ;
  • 임채영 (건국대학교 수의과대학 내과학교실) ;
  • 조수경 (건국대학교 수의과대학 내과학교실) ;
  • 이소영 (건국대학교 수의과대학 내과학교실) ;
  • 허라영 (건국대학교 수의과대학 내과학교실)
  • Published : 2006.12.30

Abstract

A 3-year-old, spayed female Shih-tzu dog was presented due to acute vomiting, diarrhea, and generalized weakness. The dog had generalized weakness, increased respiratory rate, and respiratory muscle effect. Neurologic examination revealed appendicular muscular weakness and decreased in tone of the anal sphincter. Megaesophagus was confirmed by radiographic examinations. Other than type 2 fiber atrophy, no specific abnormalities were identified in histopathologic examinations of muscle biopsies from the left pelvic limb. Serum acetylcholine receptor (AChR) antibody titer was increased (0.78 nmol/L reference range, less than 0.6 nmol/L), confirming a diagnosis of acute fulminating myasthenia gravis. The dog dramatically responded to pyridostigmine bromide and had marked improvement in muscle strength, megaesophagus, and respiratory function. The dog has been successfully managed for 7 months after initial treatment.

3년령의 중성화된 암컷 시츄 견이 급성의 구토, 설사 및 전신 쇠약으로 인하여 내원하였다. 환자는 전신 쇠약, 호흡수 증가 및 노력성 호흡을 나타냈으며 신경 검사 상에서는 사지 근육 쇠약과 항문 조임근의 긴장도가 감소하였다. 방사선 검사를 통하여 거대식도가 확인되었다. 좌측 뒷다리 근육의 생검에 대한 조직병리 검사 상에서는 2형섬유 위축을 제외하고는 특이적인 이상 소견이 발견되지 않았다. 혈청의 아세틸콜린 수용체 항체가가 상승되어 있어 (0.78 nmol/L; 정상 범위, 0.6 nmol/L 이하) 급성 전격 중증 근육무력증으로 확진되어졌다. 환자는 pyridostigmine bromide에 대하여 극적으로 반응하여, 근육 강도, 거대식도, 그리고 호흡 기능이 현저하게 호전되었으며 현재 7개월 동안 환경은 성공적으로 관리되어져 오고 있다.

Keywords

References

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