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During this admission, she developed transient right-sided facial droop and slurred speech which resolved spontaneously; however, the patient became unresponsive and desaturated with severe decompensated type 2 respiratory failure. Patient was supported with non-invasive ventilation (biphasic positive airway pressure) for few days. Myasthenia gravis was suspected due to clinical features and confirmed by the high titre of acetylcholine receptor antibody titre.<\/jats:p>","DOI":"10.1136\/bcr-2019-231690","type":"journal-article","created":{"date-parts":[[2019,11,28]],"date-time":"2019-11-28T10:45:27Z","timestamp":1574937927000},"page":"e231690","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Persistent type 2 respiratory failure on background of advanced thymoma with lung metastases"],"prefix":"10.1136","volume":"12","author":[{"given":"Abrar","family":"Munir","sequence":"first","affiliation":[{"name":"Acute Internal Medicine, North Manchester General Hospital, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohsin Ijaz","family":"Khan","sequence":"additional","affiliation":[{"name":"Acute Internal Medicine, North Manchester General Hospital, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason Kah Chun","family":"Cheong","sequence":"additional","affiliation":[{"name":"Acute Internal Medicine, North Manchester General Hospital, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,11,28]]},"reference":[{"key":"2025082622462668000_12.11.e231690.1","doi-asserted-by":"crossref","first-page":"505.3","DOI":"10.1212\/WNL.0000000000003570","article-title":"Author response: international consensus guidance for management of myasthenia gravis: Executive summary","volume":"88","author":"Sanders","year":"2017","journal-title":"Neurology"},{"key":"2025082622462668000_12.11.e231690.2","doi-asserted-by":"crossref","unstructured":"Kumar R . 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