{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T04:59:27Z","timestamp":1788584367695,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Very late\u2010onset myasthenia gravis (VLOMG) is rare myasthenia gravis (MG) that begins after the age of 65\u2009years. Here, we describe a 72\u2010year\u2010old patient who presented with dysphagia. Upper gastrointestinal radiography revealed delayed initiation of swallowing in the pharynx and inadequate opening of the upper esophageal sphincter. Notably, there was a gradual decrease in laryngeal elevation, which strongly suggested MG. Additionally, the frequency of swallowing was reduced, and anti\u2010acetylcholine receptor (anti\u2010AChR) antibodies were positive. Due to type I respiratory failure, the patient required a tracheotomy and ventilator support. By the time of hospital discharge, the patient was able to walk out independently with a stomach tube and tracheotomy cannula. In conclusion, VLOMG should be considered in patients over 65\u2009years old who present with sudden, isolated dysphagia or dysarthria, particularly when there is a gradual decrease in laryngeal elevation during swallowing as observed on upper gastrointestinal radiography.<\/jats:p>","DOI":"10.1002\/ccr3.70434","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T13:09:06Z","timestamp":1744895346000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Very Late\u2010Onset Myasthenia Gravis Presenting With Dysphagia and Gradual Decrease in Laryngeal Elevation During Repeated Swallowing: A Case Report"],"prefix":"10.1002","volume":"13","author":[{"given":"Yujuan","family":"Han","sequence":"first","affiliation":[{"name":"Tiantan Xiaotangshan Rehabilitation Center Beijing Xiaotangshan Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawei","family":"Zang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Beijing Tiantan Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0796-0169","authenticated-orcid":false,"given":"Xiaoping","family":"Kang","sequence":"additional","affiliation":[{"name":"Tiantan Xiaotangshan Rehabilitation Center Beijing Xiaotangshan Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-024-07368-0"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008903"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2023.02.013"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S423098"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/01616412.2018.1525121"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00297-0"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-020-0345-3"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13760-022-01900-9"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e28893"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/01616412.2018.1525121"},{"issue":"6","key":"e_1_2_12_12_1","article-title":"Myasthenia Gravis Mimicking Stroke: A Case Series With Sudden Onset Dysarthria","volume":"36","author":"Tremolizzo L.","year":"2015","journal-title":"Neuroscience"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.14-6-640"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-10342-3"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14052"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008688"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27832"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489418806918"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-021-10338-9"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27369"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.70434","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T14:54:47Z","timestamp":1764255287000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.70434"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1002\/ccr3.70434"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.70434","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2024-11-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70434"}}