{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T17:33:49Z","timestamp":1776447229047,"version":"3.51.2"},"reference-count":20,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,6,5]]},"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>A woman in her 90s with a background of myasthenia gravis and atrial fibrillation presented to hospital following a fall. While in the emergency department it was noted that she was in atrial fibrillation with a fast-ventricular response and as part of her management was given intravenous magnesium. Following this she developed acute respiratory failure and required intubation and ventilation. The patient recovered quickly and was extubated in the intensive care unit the next day. On subsequent days, the patient received two further doses of intravenous magnesium before the link was identified. On both of these occasions she again developed respiratory failure which were managed with non-invasive ventilation. This case highlights the importance of all members of the team being aware of the drugs that can induce a myasthenic crisis. It also stimulates further research into the development of a guide of how to safely treat symptomatic hypomagnesaemia in patients with myasthenia gravis.<\/jats:p>","DOI":"10.1136\/bcr-2022-250455","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T11:05:30Z","timestamp":1655982330000},"page":"e250455","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Intravenous magnesium sulfate inducing acute respiratory failure in a patient with myasthenia gravis"],"prefix":"10.1136","volume":"15","author":[{"given":"Kayleigh","family":"Jessop","sequence":"first","affiliation":[{"name":"Anaesthetics, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,6,23]]},"reference":[{"key":"2025082712320610000_15.6.e250455.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2014.01.003"},{"key":"2025082712320610000_15.6.e250455.2","doi-asserted-by":"publisher","DOI":"10.1038\/nri916"},{"key":"2025082712320610000_15.6.e250455.3","doi-asserted-by":"crossref","DOI":"10.1016\/j.expneurol.2015.01.007","article-title":"Electrophysiological analysis of neuromuscular synaptic function in myasthenia gravis patients and animal models","volume":"270","author":"Plomp","year":"2015","journal-title":"Exp Neurol"},{"key":"2025082712320610000_15.6.e250455.4","doi-asserted-by":"publisher","DOI":"10.1177\/1941875210382918"},{"key":"2025082712320610000_15.6.e250455.5","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.48.5.1253"},{"key":"2025082712320610000_15.6.e250455.6","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1113\/jphysiol.1954.sp005114","article-title":"The nature of the neuromuscular block produced by magnesium","volume":"124","author":"Del Castillo","year":"1954","journal-title":"J Physiol"},{"key":"2025082712320610000_15.6.e250455.7","doi-asserted-by":"crossref","first-page":"495","DOI":"10.14503\/THIJ-14-4584","article-title":"Acute respiratory failure induced by magnesium replacement in a 62-year-old woman with myasthenia gravis","volume":"42","author":"Singh","year":"2015","journal-title":"Tex Heart Inst J"},{"key":"2025082712320610000_15.6.e250455.8","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2014-204163","article-title":"Myasthenia gravis masquerading as dysphagia: unveiled by magnesium infusion","volume":"2014","author":"Klair","year":"2014","journal-title":"BMJ Case Rep"},{"key":"2025082712320610000_15.6.e250455.9","first-page":"148","article-title":"New diagnosis of myasthenia gravis following magnesium replacement","volume":"8","author":"Kemnic","year":"2020","journal-title":"Am J Case Rep"},{"key":"2025082712320610000_15.6.e250455.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2007.03.012"},{"key":"2025082712320610000_15.6.e250455.11","first-page":"1","article-title":"Severe preeclampsia in the setting of myasthenia gravis","volume":"2017","author":"Lake","year":"2017","journal-title":"Case Rep Obstet Gynecol"},{"key":"2025082712320610000_15.6.e250455.12","doi-asserted-by":"publisher","DOI":"10.1093\/ndtplus\/sfr163"},{"key":"2025082712320610000_15.6.e250455.13","doi-asserted-by":"publisher","DOI":"10.1177\/0885066604271539"},{"key":"2025082712320610000_15.6.e250455.14","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2013-305572"},{"key":"2025082712320610000_15.6.e250455.15","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-40757"},{"key":"2025082712320610000_15.6.e250455.16","first-page":"97","article-title":"Myasthenic crisis","volume":"102","author":"Chaudhuri","year":"2009","journal-title":"Int J Gen Med"},{"key":"2025082712320610000_15.6.e250455.17","doi-asserted-by":"publisher","DOI":"10.1159\/000117380"},{"key":"2025082712320610000_15.6.e250455.18","doi-asserted-by":"crossref","DOI":"10.1177\/1756285608093888","article-title":"Progress in the treatment of myasthenia gravis","volume":"1","author":"Gold","year":"2008","journal-title":"Ther Adv Neurol Disord"},{"key":"2025082712320610000_15.6.e250455.19","unstructured":"Joint Formulary Committee . 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