[Pubmed] Juvenile autoimmune myasthenia gravis: diagnostic utility of diurnal ptosis and the ice pack test

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BMJ Case Rep. 2026 Jun 19;19(6):e272395. doi: 10.1136/bcr-2026-272395.

ABSTRACT

Juvenile autoimmune myasthenia gravis (JAMG) is uncommon in children and extremely rare in infants. The condition is frequently recognised late since it mimics congenital and neuromuscular disorders. We report a case of a toddler presenting with fluctuating bilateral ptosis that worsened in the evening. The bedside ice pack test was positive, and serum acetylcholine receptor antibodies confirmed the diagnosis. A chest CT scan revealed no abnormalities in the thymus. The child showed a good response to anticholinesterase treatment. This case emphasises the significance of recognising fatigable ptosis and employing simple bedside assessments for the early diagnosis of juvenile autoimmune myasthenia gravis.

PMID:42320955 | DOI:10.1136/bcr-2026-272395


Source: https://pubmed.ncbi.nlm.nih.gov/4232095 ... 1&v=2.20.0