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  <titleInfo>
    <title>Case 24-2026: A 74-year-old man with dyspnea, proximal muscle weakness, and hypoxemia</title>
  </titleInfo>
  <name type="personal">
    <namePart>Ankomah, Pierre O.</namePart>
    <role>
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    <role>
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  <name type="personal">
    <namePart>Czawlytko, Cynthia L.</namePart>
  </name>
  <name type="personal">
    <namePart>El Khoury, Joseph B.</namePart>
  </name>
  <name type="personal">
    <namePart>Andrianus, Stefen</namePart>
  </name>
  <name type="personal">
    <namePart>Donnelly-Morell, M. Lauren</namePart>
  </name>
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    <issuance>monographic</issuance>
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  <language>
    <languageTerm authority="iso639-2b" type="code">spa</languageTerm>
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  <language>
    <languageTerm authority="iso639-2b" type="code">eng</languageTerm>
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    <extent>páginas: 804-815</extent>
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  <abstract>The patient had been in his usual state of health, with hypertension and dyslipidemia, until 7 months before the current presentation, when intermittent binocular diplopia developed. Evaluation by an ophthalmologist affiliated with this hospital revealed ptosis in the right eye and fluctuating strabismus that was not associated with a cranial nerve abnormality. Testing for acetylcholine receptor antibodies was positive, and computed tomography (CT) of the chest showed a normal thymus. Treatment with pyridostigmine was started for presumed ocular myasthenia gravis, and the patient was referred to the neurology clinic affiliated with this hospital.</abstract>
  <subject>
    <topic>ALERGIA</topic>
  </subject>
  <subject>
    <topic>INMUNOLOGÍA GENERAL</topic>
  </subject>
  <subject>
    <topic>ENCEFALITIS</topic>
  </subject>
  <subject>
    <topic>OTORRINOLARINGOLOGÍA</topic>
  </subject>
  <subject>
    <topic>OFTALMOLOGÍA</topic>
  </subject>
  <subject>
    <topic>INFECCIONES VIRALES</topic>
  </subject>
  <subject>
    <topic>NEUROLOGÍA</topic>
  </subject>
  <subject>
    <topic>MENINGITIS</topic>
  </subject>
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    <titleInfo>
      <title>The New England Journal of Medicine</title>
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    <originInfo>
      <publisher>Massachusetts NEJM Group</publisher>
    </originInfo>
    <identifier>NEJM12</identifier>
    <identifier type="issn">0028-4793</identifier>
    <identifier type="local">ESSALUD</identifier>
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    <recordCreationDate encoding="marc">      </recordCreationDate>
    <recordChangeDate encoding="iso8601">20260821145452.0</recordChangeDate>
    <recordIdentifier>ESSALUD</recordIdentifier>
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