抗水通道蛋白4抗体阳性患者下丘脑病变相关的体温过低、低血压、嗜睡和肥胖：病例报告及文献综述
Hypothermia, hypotension, hypersomnia, and obesity associated with hypothalamic lesions in a patient positive for the anti-aquaporin 4 antibody: a case report and literature review.
作者信息
Suzuki Keisuke, Nakamura Toshiki, Hashimoto Kenichi, Miyamoto Masayuki, Komagamine Tomoko, Nagashima Takahide, Izawa Naoki, Kanbayashi Takashi, Takahashi Toshiyuki, Hirata Koichi
机构信息
Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
出版信息
Arch Neurol. 2012 Oct;69(10):1355-9. doi: 10.1001/archneurol.2012.300.
OBJECTIVE
To describe a patient positive for the anti-aquaporin 4 antibody with hypothalamic lesions showing hypothermia, hypotension, hypersomnia, and obesity.
DESIGN
Case report.
SETTING
University hospital.
PATIENT
We describe a 21-year-old woman who was positive for anti-aquaporin 4 antibody and presented with hypothermia, hypotension, and hypersomnia owing to bilateral hypothalamic lesions as the only abnormal clinical finding.
RESULTS
Immediate steroid administration resulted in significant improvement of the patient's vital signs and imaging findings; however, her cognitive impairment and sleepiness persisted, and she subsequently developed obesity. Decreased cerebrospinal fluid orexin levels and sleep studies confirmed the diagnosis of narcolepsy due to medical condition. Physicians should be aware that neuromyelitis optica spectrum disorders can initially involve the hypothalamus.
CONCLUSIONS
We emphasize that measurement of anti-aquaporin 4 antibody is of clinical importance in the differential diagnosis of hypothalamic lesions.
目的
描述一名抗水通道蛋白4抗体阳性且伴有下丘脑病变，表现为体温过低、低血压、嗜睡和肥胖的患者。
设计
病例报告。
地点
大学医院。
患者
我们描述了一名21岁女性，其抗水通道蛋白4抗体呈阳性，因双侧下丘脑病变出现体温过低、低血压和嗜睡，这是唯一异常的临床发现。
结果
立即给予类固醇治疗后，患者的生命体征和影像学表现有显著改善；然而，她的认知障碍和嗜睡仍然存在，随后还出现了肥胖。脑脊液中食欲素水平降低以及睡眠研究证实了因疾病导致的发作性睡病的诊断。医生应意识到视神经脊髓炎谱系障碍最初可能累及下丘脑。
结论
我们强调抗水通道蛋白4抗体的检测在下丘脑病变的鉴别诊断中具有临床重要性。
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