{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T13:01:20Z","timestamp":1755694880015,"version":"3.41.2"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Myasthenia gravis (MG) is a rare autoimmune neuromuscular disorder characterised by varying degrees of skeletal muscle weakness. Diagnosing MG represents a challenge for clinicians due to the diversity of disease manifestations. We present an unusual case of this disease in an older gentleman in which the patient reported swollen tongue and lips which was incorrectly diagnosed and treated as angioedema. Months later, he developed progressive dysphagia, dysarthria and weight loss. The diagnosis was further delayed by the identification of a hiatal hernia and Zenker\u2019s diverticulum after extensive investigation for dysphagia. A total of 15\u00a0months on prompted by persistent symptoms, the patient was found to have MG by positive antibody test and Electromyogram. Treatment was initiated which led to a rapid and significant relief of his symptoms.<\/jats:p>","DOI":"10.1093\/ageing\/afad230","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T15:12:09Z","timestamp":1703862729000},"source":"Crossref","is-referenced-by-count":2,"title":["Atypical Myasthenia gravis in an older person resulting in delayed diagnosis: a case report"],"prefix":"10.1093","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7313-5773","authenticated-orcid":false,"given":"Maimuna","family":"Adamu","sequence":"first","affiliation":[{"name":"Department of Medicine, Peterborough City Hospital, Northwest Anglia NHS Foundation Trust , Peterborough, Cambridgeshire , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Saka","sequence":"additional","affiliation":[{"name":"Medicine for Older People, Peterborough City Hospital, Northwest Anglia NHS Foundation Trust , Peterborough, Cambridgeshire , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,12,28]]},"reference":[{"key":"2023122915100804200_ref1","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1196\/annals.1405.040","article-title":"Myasthenia gravis in the elderly: is it different?","volume":"1132","author":"Aarli","year":"2008","journal-title":"Ann N Y Acad Sci"},{"key":"2023122915100804200_ref2","doi-asserted-by":"crossref","first-page":"58","DOI":"10.4103\/2277-9175.151874","article-title":"Life-threatening misdiagnosis of bulbar onset myasthenia gravis as a motor neuron disease: how much can one rely on exaggerated deep tendon reflexes","volume":"4","author":"Basiri","year":"2015","journal-title":"Adv Biomed Res"},{"key":"2023122915100804200_ref3","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/S0194-59989770334-6","article-title":"Swollen tongue: a presentation of Myasthenia gravis","volume":"116","author":"Davison","year":"1997","journal-title":"Otolaryngol Head Neck Surg"},{"key":"2023122915100804200_ref4","article-title":"Delayed diagnosis of atypical presentation of Myasthenia gravis","volume":"5","author":"Mustafa","year":"2018","journal-title":"Eur J Case Rep Intern Med"},{"key":"2023122915100804200_ref5","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1136\/ard.45.5.428","article-title":"Heterozygous C2 deficiency associated with angioedema, myasthenia gravis, and systemic lupus erythematosus","volume":"45","author":"Efthimiou","year":"1986","journal-title":"Ann Rheum Dis"}],"container-title":["Age and Ageing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/52\/12\/afad230\/54916557\/afad230.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/52\/12\/afad230\/54916557\/afad230.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T15:12:13Z","timestamp":1703862733000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ageing\/article\/doi\/10.1093\/ageing\/afad230\/7503297"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,1]]},"references-count":5,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ageing\/afad230","relation":{},"ISSN":["0002-0729","1468-2834"],"issn-type":[{"type":"print","value":"0002-0729"},{"type":"electronic","value":"1468-2834"}],"subject":[],"published-other":{"date-parts":[[2023,12,1]]},"published":{"date-parts":[[2023,12,1]]},"article-number":"afad230"}}