Abstract
Introduction: Acute respiratory failure with irritative myopathy and high serum creatine kinase in the elderly has a board differential diagnosis and is unusual presentation of mitochondrial cytopathy. Method: We report a case of 58-year-old Thai woman who developed acute respiratory failure due to CO2 retention during her OPD visit. She had 8 years history of Thyrotoxicosis which had been treated in the other hospital. She also had history of progressive limb muscles weakness for months but this was not disturbed her daily activity.
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