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Problem solving in clinical practice
Problem-solving in clinical practice: breathing difficulty and muscle weakness following allogeneic haematopoietic stem cell transplantation
  1. Bashaer Albulushi1,
  2. Farah Thabet1,
  3. Saad Alshahwan1,
  4. Yasser Elborai1,2,
  5. Nawaf Alkhayat1,
  6. Mohamed Alshahrani1,
  7. Brahim Tabarki1
  1. 1Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
  2. 2Department of Pediatric Oncology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
  1. Correspondence to Professor Brahim Tabarki, Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia; btabarki{at}hotmail.com

Abstract

Acute weakness and dyspnoea are unusual presentation after allogeneic haematopoietic stem cell transplantation (HSCT) complicated by chronic graft-versus-host disease (GVHD). The differential diagnosis and management are challenging for the paediatrician. This case chronicles the diagnostic journey of a child who presented with weakness, dyspnoea and difficulty in speech, 2 years after allogeneic HSCT and GVHD and explores the approach to neurological manifestations in this context.

  • myasthenia gravis
  • bone marrow transplant
  • graft versus host disease

https://doi.org/10.1136/archdischild-2019-317281

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    Footnotes

    • Twitter @Yasser Elborai

    • Contributors FT and BA: drafting the manuscript, manuscript concept/design. SA: critical revision of the manuscript. YE: critical revision of the manuscript. BT: manuscript concept/ design, critical revision of the manuscript and manuscript supervision.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.