A case of left blepharoptosis in a patient with type 2 diabetes mellitus and myasthenia gravis

Kunihisa Kobayashi, Naoichi Sato, Kenji Tashiro, Hideyuki Yoshizumi, Tsuyoshi Karashima, Toyoshi Inoguchi, Hajime Nawata

Research output: Contribution to journalArticle

Abstract

Background: The most common cause of blepharoptosis in individuals with diabetes mellitus is oculomotor paralysis due to diabetic mononeuropathy. Case Report: A 56-year-old male presented to an ophthalmologist with left blepharoptosis. Diabetic preproliferative retinopathy was diagnosed and the patient was referred to National Hospital Organization Kyushu Medical Center for further evaluation. On admission, right blepharoptosis was also noted, and his fasting plasma glucose and HbA 1c were 168 mg/dℓ and 9.2%, respectively. Proteinuria was detected and the Achilles tendon reflex was absent. He reported a 6-day history of diplopia and right blepharoptosis. On ophthalmic examination, the pupillary reaction to light was normal and ocular movement was smooth in all directions but restricted in range. The blepharoptosis improved after administration of edrophonium chloride. A test for serum anti-acetylcholine receptor antibody was positive and computed tomography of the chest showed thymoma. Later, he had a rapid onset of myasthenic crisis and underwent emergent thymectomy. Conclusions: Myasthenia gravis as well as cerebral aneurysm or brain tumor should be considered in the differential diagnosis of blepharoptosis.

Original languageEnglish
Pages (from-to)940-943
Number of pages4
JournalFolia Ophthalmologica Japonica
Volume55
Issue number12
Publication statusPublished - Dec 1 2004

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Blepharoptosis
Myasthenia Gravis
Type 2 Diabetes Mellitus
Edrophonium
Ophthalmoplegia
Stretch Reflex
Thymectomy
Achilles Tendon
Diplopia
Thymoma
Diabetic Neuropathies
Muscle Weakness
Intracranial Aneurysm
Cholinergic Receptors
Diabetic Retinopathy
Eye Movements
Proteinuria
Brain Neoplasms
Fasting
Diabetes Mellitus

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Kobayashi, K., Sato, N., Tashiro, K., Yoshizumi, H., Karashima, T., Inoguchi, T., & Nawata, H. (2004). A case of left blepharoptosis in a patient with type 2 diabetes mellitus and myasthenia gravis. Folia Ophthalmologica Japonica, 55(12), 940-943.

A case of left blepharoptosis in a patient with type 2 diabetes mellitus and myasthenia gravis. / Kobayashi, Kunihisa; Sato, Naoichi; Tashiro, Kenji; Yoshizumi, Hideyuki; Karashima, Tsuyoshi; Inoguchi, Toyoshi; Nawata, Hajime.

In: Folia Ophthalmologica Japonica, Vol. 55, No. 12, 01.12.2004, p. 940-943.

Research output: Contribution to journalArticle

Kobayashi, K, Sato, N, Tashiro, K, Yoshizumi, H, Karashima, T, Inoguchi, T & Nawata, H 2004, 'A case of left blepharoptosis in a patient with type 2 diabetes mellitus and myasthenia gravis', Folia Ophthalmologica Japonica, vol. 55, no. 12, pp. 940-943.
Kobayashi K, Sato N, Tashiro K, Yoshizumi H, Karashima T, Inoguchi T et al. A case of left blepharoptosis in a patient with type 2 diabetes mellitus and myasthenia gravis. Folia Ophthalmologica Japonica. 2004 Dec 1;55(12):940-943.
Kobayashi, Kunihisa ; Sato, Naoichi ; Tashiro, Kenji ; Yoshizumi, Hideyuki ; Karashima, Tsuyoshi ; Inoguchi, Toyoshi ; Nawata, Hajime. / A case of left blepharoptosis in a patient with type 2 diabetes mellitus and myasthenia gravis. In: Folia Ophthalmologica Japonica. 2004 ; Vol. 55, No. 12. pp. 940-943.
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