Deguchi Shoko, Deguchi Kentaro, Sato Kota, Yunoki Taijun, Omote Yoshio, Morimoto Nobutoshi, Kurata Tomoko, Ikeda Masami, Takahashi Toshiyuki, Aoki Masashi, Abe Koji
Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan.
Intern Med. 2012;51(18):2617-20. doi: 10.2169/internalmedicine.51.7898. Epub 2012 Sep 15.
We herein report the case of a 60-year-old man showing overexpression of creatine kinase (hyperCKemia) related to initial and recurrent attacks of neuromyelitis optica (NMO). He showed reduced vision, ataxia and dysesthesia, but no symptoms originating in the muscles. Magnetic resonance imaging (MRI) revealed lesions in the optic nerve, medulla oblongata, and spinal cord similar to typical NMO patients. However, femoral MRI and whole positron emission tomography (PET) demonstrated no abnormal findings during an episode of hyperCKemia. This case suggests that hyperCKemia is partly involved in the pathogenesis of NMO in both the central nervous system and myofiber surface, which is usually difficult to detect by clinical imaging modalities alone.
我们在此报告一例60岁男性病例，其肌酸激酶过度表达（高肌酸激酶血症）与视神经脊髓炎（NMO）的初次发作及复发相关。他出现视力下降、共济失调和感觉异常，但无肌肉源性症状。磁共振成像（MRI）显示视神经、延髓和脊髓有病变，与典型NMO患者相似。然而，在高肌酸激酶血症发作期间，股骨MRI和全身正电子发射断层扫描（PET）均未发现异常。该病例提示，高肌酸激酶血症在中枢神经系统和肌纤维表面的NMO发病机制中均有部分参与，而这通常仅靠临床成像方式难以检测到。
