[en] Cosmetic or therapeutic use of botulinum toxin type A (BoNT-A) is usually safe but can rarely cause iatrogenic botulism. Iatrogenic botulism and myasthenia gravis (MG) share similar clinical features, because both BoNT-A and anti-acetylcholine receptor antibodies impair neuromuscular transmission. We report a patient who underwent cosmetic BoNT-A injection and later developed serious local and systemic adverse reactions. The peculiarity of this case is that a latent seropositive MG was eventually discovered, suggesting that both iatrogenic botulism and MG contributed to the clinical picture. This patient is one of the less than 10 reported cases worldwide in whom MG was unmasked by BoNT-A injection. He is the first to be assessed in detail by single-fiber electromyography (SFEMG). This case emphasises the risk associated with BoTN-A injection in patients with subclinical impairment of neuromuscular transmission and prompts the search for MG in case of exaggerated response.
Disciplines :
Neurology
Author, co-author :
Timmermans, Grégory ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de neurologie
DEPIERREUX, Frédérique ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de neurologie
WANG, François-Charles ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service de médecine de l'appareil locomoteur
HANSEN, Isabelle ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Unité de neuro immunologie clinique
MAQUET, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de neurologie
Language :
English
Title :
Cosmetic injection of botulinum toxin unmasking subclinical myasthenia gravis : a case report and literature review
Alternative titles :
[fr] Injection cosmétique de toxine botulique démasquant une myasthénie grave infraclinique : un rapport de cas et une revue de la littérature
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