Puzzling Patient

[AFV]

Hi. I am an intern in a hospital in the philippines and i just wanted to get some thoughts concernin a patient who has been puzzling us.  LC, 14 yo male, presented acutely 4 months prior with palpitations while havin an asthma attack.  Xray and ECG taken were normal. 3 months prior to consult, patient had unilateral bulging of right eye assoc with blurrin of vision, which resolved in a week.  CT scan take (cranial an orbit) revealed ethmoid and maxillary sinusitis.  2 months prior to consult, patient started havin weakness, Lower ext>upper extremity, improved with rest, and afternoon>morning.  The patient then had bulging of L eye, not associated with blurrin of vision.  The patient had progressive weakness... persisence of palpitations, became irritable and heat intolerant.  

Vitals & Physical exam revealed hypertension, tachycardia, normal Rest rate, normal temperature, bilateral bulging of eyes, ptosis bilateral, pupils equally round and reactive to light, frozen eyeball bilateral... funduscopy normal except what appears to be pigmentary retinopathy bilaterally. While admitted, patient started on propranolol... after he walked to the bathroom and back to the bed, about 15 meters he suddenly became tachycardic, tachypneic, had difficulty breathing, and had chest pain... patient then had to be resuscitated and eventually intubated. patient still has chest pain, ECG revealed septal myocardial infarct.  Laboratory findings revealed increased T3, T4, CPKMB, Troponin I.  Patient developed aspiration pneumonia and currently bein treated with antibiotics.  Tensilon test not yet tested... patient intermittently desaturates even while on vent. respiration...

Unremarkable past and family history.

workin diagnosis:  Hyperthyroidism, Myasthenia Gravis, Guillain Barre Miller-Fisher Type, Kearns-Sayre Syndrome.

With only textbooks to work with and barely any recent journals available, can someone please help? any suggestions? Please email me asmspinoy_1***@**** if you have any suggestions.. thanks.

[wishforchange]

What are you doing?????????  Does this patient, anonymous as they are here, have your permission to publicly post their medical details on a public forum?  Has it occurred to you that they or their family or your colleagues may read this post?
This is an extremely unprofessional breach of your patient's confidentiality, if you do not have their consent.  I hope that this is found out and you are suitably disciplined.
PLEASE DO NOT EVER PUBLISH PATIENT'S PRIVATE DETAILS WITHOUT THEIR CONSENT!
I am horrified.  Am just glad I don't live in the Phillipines so there is no chance you are my doctor.
I make no apologies for the strength of my response.