Nishihara T, Hashiguchi S, Ogasawara N, Shirabe T, Yoshino H
Department of Internal Medicine, Takamatsu Red Cross Hospital.
Rinsho Shinkeigaku. 1998 Oct-Nov;38(10-11):926-30.
We reported a case of mononeuropathy multiplex associated with anti-GM1 and -SGLPG antibodies in a patient with ongoing Hashimoto disease. A 56-year-old woman was admitted with asymmetrical patchy sensory and motor disturbance in the extremities. Muscle atrophy and weakness in the left palm and bilateral tibialis anterior muscles were also noted. Deep tendon reflexes were normal in all the extremities. Superficial and deep sensations were reduced in the hands and feet bilaterally, and the distribution of sensory loss was irregular. Her serum was positive for antinuclear antibody, rheumatoid factor, anti-RNP antibody, and anti-SS-A antibody. Serial electrophysiological studies suggested that the predominant process was axonal degeneration of the sensorimotor nerves. On sural nerve biopsy, there were no findings of vasculitis but severe axonal degeneration was observed. Thin-layer chromatography with immunostaining revealed anti-GM1 and -SGLPG antibodies. Treatment with corticosteroids was successful. In this case, the anti-GM1 antibody may have played a role in the pathogenesis of mononeuropathy multiplex associated with autoimmune disease.
我们报告了一例患有桥本氏病的患者,其出现了与抗GM1和抗SGLPG抗体相关的多发性单神经病。一名56岁女性因四肢不对称性片状感觉和运动障碍入院。还注意到左手掌和双侧胫前肌有肌肉萎缩和无力。所有肢体的深腱反射均正常。双侧手足的浅感觉和深感觉减退,感觉丧失的分布不规则。她的血清抗核抗体、类风湿因子、抗RNP抗体和抗SS - A抗体均呈阳性。系列电生理研究表明,主要过程是感觉运动神经的轴索性变性。在腓肠神经活检中,未发现血管炎的表现,但观察到严重的轴索性变性。薄层色谱免疫染色显示有抗GM1和抗SGLPG抗体。皮质类固醇治疗取得成功。在该病例中,抗GM1抗体可能在与自身免疫性疾病相关的多发性单神经病的发病机制中起了作用。