Toscano Antonio, Rodolico Carmelo, Benvenga Salvatore, Girlanda Paolo, Laurà Matilde, Mazzeo Anna, Nobile-Orazio Eduardo, Trimarchi Francesco, Vita Giuseppe, Messina Corrado
Department of Neuroscience, Psychiatry and Anesthesiology, University of Messina, Via C. Valeria, 98125, Messina, Italy.
Neuromuscul Disord. 2002 Aug;12(6):566-8. doi: 10.1016/s0960-8966(01)00311-x.
Motor neuropathy with multifocal conduction blocks represents a recently identified autoimmune disorder of the peripheral nerve myelin. Association of motor neuropathies or neuronopathies with thyroid disorders, such as hyperthyroidism, hypothyroidism or thyroid neoplasms has been rarely described. We studied a 61-year-old man with a 2-year-history of slowly progressive weakness of the left limbs with atrophy and fasciculations. Nerve conduction velocity studies revealed multifocal motor conduction blocks. Serum IgM titer of antibodies against GM1 was elevated (1:1280; n.v. up to 1:640). Thyroid studies were compatible with Hashimoto's thyroiditis. Therapy with high dose intravenous immunoglobulins was followed by a prompt clinical recovery. Then the disease assumed an intravenous immunoglobulins dependent course with a full clinical, but transient, recovery. This is the first observation of an association of multifocal motor neuropathy with high titers of GM1 and Hashimoto's thyroiditis and reinforces the multifocal motor neuropathy autoimmune origin as well as the repeated clinical recoveries after intravenous immunoglobulins. This case also suggests to deeply investigate the thyroid function in patients with multifocal motor neuropathy.
伴有多灶性传导阻滞的运动神经病是一种最近发现的周围神经髓鞘自身免疫性疾病。运动神经病或神经元病与甲状腺疾病（如甲状腺功能亢进、甲状腺功能减退或甲状腺肿瘤）的关联很少被描述。我们研究了一名61岁男性，他有2年的左下肢缓慢进行性无力伴萎缩和肌束震颤病史。神经传导速度研究显示多灶性运动传导阻滞。抗GM1抗体的血清IgM滴度升高（1:1280；正常范围上限为1:640）。甲状腺检查结果符合桥本甲状腺炎。高剂量静脉注射免疫球蛋白治疗后临床迅速恢复。然后疾病呈现出依赖静脉注射免疫球蛋白的病程，临床完全恢复但为短暂性。这是首次观察到多灶性运动神经病与高滴度GM1及桥本甲状腺炎之间的关联，强化了多灶性运动神经病的自身免疫起源以及静脉注射免疫球蛋白后反复出现的临床恢复情况。该病例还提示对多灶性运动神经病患者应深入检查甲状腺功能。
